Maximus is seeking an Eligibility Verification Specialist to support the U.S. Office of Personnel Management's (OPM) FEHB Protection Act Compliance and Verification Program.
This CSR II position serves as a frontline customer service representative for Federal Employees Health Benefits (FEHB) and Postal Service Health Benefits (PSHB) Program enrollees, providing inbound telephone support for dependent eligibility verification.
The CSR II responds to questions regarding dependent eligibility verification requirements, acceptable documentation, submission deadlines, case status, and verification processes, and assists enrollees with Portal access, document submission, and navigation of program resources.
Remote Remote: Must reside within 50 miles of McAllen, TX location
Please note: This position is contingent upon contract award.
Essential Duties and Responsibilities:
- Provides customer service for basic and routine inquiries and problems via multiple possible channels (i.e. telephone, emails, web chats, or written letters).
- Calls are predominantly routine, but may require deviation from standard screens, scripts, and procedures.
- Uses computerized system for tracking, information gathering, and/or troubleshooting.
- Provides feedback when needed, provide input on call trends, processes, procedures, and training.
- May respond to customer inquiries by referring them to published materials, secondary sources, or more senior staff.
- Provides inbound telephone support to enrollees on dependent eligibility verification requirements, acceptable documentation, deadlines, and case status.
- Assists callers with Portal access, login issues, and document upload using OPM-approved scripts and knowledge resources.
- Authenticates callers before sharing case information and protects PII and PHI in line with privacy and security requirements.
- Documents each interaction accurately in the OPM FEHB Protection Act Portal or other approved system of record.
- Escalates complex questions, reconsideration requests, language or accessibility needs, and potential fraud indicators per approved procedures.
- Meets attendance, schedule adherence, call quality, and documentation accuracy standards.
- High School diploma or equivalent with 6 months of customer service experience.
- May have additional training or education in area of specialization.
- - High School diploma or equivalent with 6 months of customer service experience required
- May have additional training or education in area of specialization.
- Must be able to obtain and maintain a Moderate Risk Public Trust (5C) suitability determination, including completion of all Government-required background investigations, fingerprinting, credentialing, and security training requirements.
- Must be a U.S. Citizen
*Position is contingent upon contract award*
- This is a remote role. Must reside within 50 miles of McAllen, TX location
- Equipment will be provided but must meet the remote position requirement provided below.
Remote Position Requirements:
- Internet speed of 25mbps or higher required / 50 Mpbs for shared internet
connectivity (you can test this by going to
- Minimum 5mpbs upload speed.
- Connectivity to the internet via Category 5 or 6 ethernet patch cable to the
home internet router.
- Private work area and adequate power source
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.
For positions on this contract, Maximus will pay the prevailing wage rate for the location in which the employee is working, as determined by the Department of Labor. That wage rate will vary depending on locality. An applicant's salary history will not be used in determining compensation.
RemoteSkills:
Background Investigation, Customer Support/Service, Documentation, Documentation Standards, Employee Benefits, Ethernet Cable, Government, Health Plan, High School Diploma, Mail Services, On Call, Requirements Validation/Verification, Risk, Software Patches, Time Management, United States Citizen
Maximus
MAXIMUS provides business services to help governments operate health and human services programs, mostly at the state and national levels. The company's health services segment offers outsourced program management and administrative services,
Company Size:
5,000 to 9,999 employees
Industry:
Healthcare Services
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Website:
