Admin 2 - Appeals

MAXIMUS • Sacramento, CA • 1h ago

Maximus is currently seeking an Admin 2 - Appeals to join our State West team. This is a remote opportunity. This Admin provides administrative and case management support by maintaining accurate case records, processing incoming documentation, entering and validating data, and ensuring timely reporting and case tracking. The position also serves as a point of contact for case status inquiries, supports client reporting requirements, and performs quality audits to ensure compliance with established procedures.

This is a client-facing position and will require a client-specific clearance to include fingerprinting.

Essential Duties and Responsibilities:

Type/generate letters and other documents, as necessary.

Assist in the preparation of reports.

Create files in case management system.

Update status of case in case management system.

Fax and email file determination letters to interested parties.

Collect and analyze incoming data and reports from treatment providers, facilities, participants, labs and health plans to input necessary information into the system.

Respond to incoming calls from clients, health plans, providers and enrollees regarding case status, questions about the program, and the appeals process.

Perform research into invoicing issues and perform outreach to health plans regarding any unpaid invoices.

'- Enter appropriate data into computer systems.

Aid team members with case file maintenance.

Enter appropriate information into automated systems for the tracking of all cases processed.

Receive, process, and distribute incoming mail and faxes.

Produce and maintain data reports and alert management of inconsistencies or issues.

Serves as a point of contact for external inquiries from clients, enrollees, and health plans regarding case status.

Prepare and disseminate case summaries to satisfy client reporting requirements.

Validate application information against documents.

Perform other duties as may be assigned by management.

Perform audits of own work to ensure conformance with established procedures.

Minimum Requirements

'- High School diploma, GED, or equivalent required.

2-4 years of experience required.

'- 2-3 Years of applicable related job experience.

Proficiency in Microsoft Suite, Adobe, and ability to accurately perform data entry.

Excellent organizational, written, and verbal communication skills.

Ability to perform comfortably in a fast-paced, deadline-oriented work environment.

Ability to successfully execute complex tasks simultaneously with attention to detail.

Ability to work as a team, as well as independently.

Ability to work under standards-based performance measures.

Ability to apply critical thinking skills.

Ability to maintain confidentiality and security of all information processed.

Ability to @type 40 WPM.

Familiarity with virtual machines to access external networks.

Ability to work a schedule between the hours of 8:00am - 5:00pm PST Monday - Friday.

Preferred Skills an Qualifications:

Associate's Degree.

Resident of the state of California.

Prior experience working with sensitive information to include protected data.

Prior experience requesting medical records and processing documentation revisions per client request.

Please note: For this position Maximus will provide equipment to use.

Home Office Requirements:

Internet speed of 25mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)

Minimum 5mpbs upload speed

Connectivity to the internet via Category 5 or 6 ethernet patch cable to the home router

Private and secure work area and adequate power source

Must currently and permanently reside in the Continental US

Must have a smartphone which will be required to log into Maximus systems

Maximus is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics.

Minimum Salary

$21

Maximum Salary

$21

MAXIMUS

Go to Apply

Share this job

Similar Jobs

Fire Engineer, Sacramento County Airport Fire

Sacramento County • Sacramento, CA • 25min ago

IT & Engineering

Fire Engineer, Sacramento County Airport Fire Print ( https://www.governmentjobs.com/careers/sacramento/jobs/newprint/5314263 ) Apply ? Fire Engineer, Sacramento County Airport Fire Salary $112,042.08 - $123,526.08 Annua...

25min ago

Go to Apply

Fire Captain, Sacramento County Airport Fire

Sacramento County • Sacramento, CA • 25min ago

Fire Captain, Sacramento County Airport Fire Print ( https://www.governmentjobs.com/careers/sacramento/jobs/newprint/5452379 ) Apply ? Fire Captain, Sacramento County Airport Fire Salary $123,192.00 - $135,824.40 Annuall...

25min ago

Go to Apply

Facility Technician I

Sysco • Pleasant Grove, CA • 33min ago

IT & Engineering

JOB SUMMARY This is an Operations position responsible for assisting facility technician II & III with maintenance activities associated with general maintenance and repair of the facility, automatic retrieval system...

33min ago

Go to Apply

DFS Operations Manager - San Francisco

Home Depot • Rancho Cordova, CA • 1h ago

Management & Administrative

DFS Operations Manager Operations. People. Problem-Solving. Repeat. Are you someone who thrives in fast-paced environments, loves turning chaos into clarity, and enjoys leading teams to win every single day? As an Operat...

1h ago

Go to Apply

Manager Clinic Operations

Dignity Health • Woodland, CA • 1h ago

Hospital & Medical

Job Summary and Responsibilities As our Clinic Manager, you will be a visionary leader, setting the standard for exceptional patient care and empowering our teams to achieve unparalleled clinical excellence. Every day yo...

1h ago

Go to Apply

Mergers & Acquisitions Finance and Operations Manager

Deloitte • Sacramento, CA • 1h ago

Legal & Paralegal

Our Deloitte Strategy & Transactions team helps guide clients through their most critical moments and transformational initiatives. We offer comprehensive end-to-end support and advisory services, covering areas such...

1h ago

Go to Apply

Legal Assistant (Office Automation)

Executive Office for U.S. Attorneys and the Office of the U.S. Attorneys • Sacramento, CA • 1h ago

Legal & Paralegal

Summary For more information on the Department of Justice and the United States Attorneys' Offices, visit http://www.justice.gov/usao/ . As needed, additional positions may be filled using this announcement. Salary conta...

1h ago

Go to Apply

Legal Assistant (Office Automation)

Executive Office for U.S. Attorneys and the Office of the U.S. Attorneys • Sacramento, CA • 1h ago

Legal & Paralegal

1h ago

Go to Apply

Senior Attorney, Enterprise Sales

Lumen • Sacramento, CA • 1h ago

Legal & Paralegal

Lumen is the trusted network for the AI-powered world, connecting people, data, and applications through our expansive fiber network and connected ecosystem. We enable secure, high-performance connectivity across cloud,...

1h ago

Go to Apply

Warehouse Order Selector

Sysco • Pleasant Grove, CA • 1h ago

Manufacturing & Warehouse

2026 is Here Start your New Career with Sysco Sacramento NEW STARTING PAY $26.41 - $33.01 Per Hour Hiring immediately Industry-leading total rewards package On-the-job training with career growth opportunities No college...

1h ago

Go to Apply

Subscribe to get new jobs sent directly to you
(no charge, cancel anytime)