Team Lead - Appeals

MAXIMUS Richmond, VA
team lead training health government military items education workforce insurance distribution coordination supervisory
March 30, 2023
MAXIMUS
Richmond, VA
FULL_TIME

Job Description Summary



Job Summary



Essential Duties and Responsibilities:- Front-line contact for issues identified by agents, including but not limited to: complex escalated issues, unit concerns such as workload distribution/prioritizing, coordination between different project functional areas and ensuring.- Provide supervisory support to the ARU Supervisor on an as needed basis to ensure efficient production levels in the unit.- Assist the Supervisor in handling escalated calls from members and providers.- Process informal dispute resolution (IDR), appeals and complaints for enrollment and eligibility for health coverage.- Schedule Appeal Hearings utilizing approved client schedules.- Review, assess and processes requests for backdating of enrollment.- Liaison between the ARU supervisors and agents to resolve escalated issues or to provide feedback on unnecessary/inappropriate escalations to ensure proper cross-training is happening.- Assign and follow up on daily workload items to agents to ensure SLA compliance and to maintain a distributed workload.- Work in conjunction with the Account Review Manager to develop and facilitate weekly refreshers which are based on escalation trends, training opportunities identified by project/client initiatives.- Responsible for adhering to established safety standards.- Must be able to remain in a stationary position for an extended period of time.- Occasionally lift, carry, or otherwise move items weighing up to 25 pounds.- Work is constantly performed in an office environment.- Perform all other duties as assigned by management.Minimum Requirements:- High School diploma or equivalent with 6+ years experience, or Associate degree with 4+ years experience.- Typically has specialized training or education in relevant functional area.


- Eligibility experience required- Works on a variety of assignments requiring considerable judgement and initiative.- Able to draft or modify training materials and procedural documentation accurately.- Skilled in handling challenging communications with external contacts for escalated matters.



MAXIMUS Introduction

Since 1975, Maximus has operated under its founding mission of Helping Government Serve the People, enabling citizens around the globe to successfully engage with their governments at all levels and across a variety of health and human services programs. Maximus delivers innovative business process management and technology solutions that contribute to improved outcomes for citizens and higher levels of productivity, accuracy, accountability and efficiency of government-sponsored programs. With more than 30,000 employees worldwide, Maximus is a proud partner to government agencies in the United States, Australia, Canada, Saudi Arabia, Singapore and the United Kingdom. For more information, visit https://www.maximus.com.

EEO Statement

EEO Statement: Active military service members, their spouses, and veteran candidates often embody the core competencies Maximus deems essential, and bring a resiliency and dependability that greatly enhances our workforce. We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a difference for our country. We’re proud of our connections to organizations dedicated to serving veterans and their families. If you are transitioning from military to civilian life, have prior service, are a retired veteran or a member of the National Guard or Reserves, or a spouse of an active military service member, we have challenging and rewarding career opportunities available for you. A committed and diverse workforce is our most important resource. Maximus is an Affirmative Action/Equal Opportunity Employer. Maximus provides equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status or disabled status.

Pay Transparency

Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. Annual salary is just one component of Maximus's total compensation package. Other rewards may include short- and long-term incentives as well as program-specific awards. Additionally, Maximus provides a variety of benefits to employees, including health insurance coverage, life and disability insurance, a retirement savings plan, paid holidays and paid time off. Compensation ranges may differ based on contract value but will be commensurate with job duties and relevant work experience. An applicant's salary history will not be used in determining compensation. Maximus will comply with regulatory minimum wage rates and exempt salary thresholds in all instances.

Posted Max

USD $22.20/Hr.

Posted Min

USD $17.26/Hr.

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