- Handle specialized cases of significant complexity within the enrollment and eligibility domain.
- Research and address appeals as directed by supervisors, serving as a Subject Matter Expert (SME) on eligibility policies for the team, understanding its impact on related departments.
- Engage closely with management and workgroups to develop and maintain comprehensive work plan documentation.
- Monitor project statuses and deadlines, ensuring timely completion.
- Collaborate with project managers on various initiatives, overseeing progress tracking and providing essential support.
- Aid the training team during the final week of sandboxing, offering guidance, answering queries, and supporting new trainees as they transition into their respective teams.
- Conduct thorough and extensive research to assess whether a benefit recovery activity needs to be completed.
- Conduct thorough research to evaluate if a referral to the fraud team is appropriate.
- Use state CODY system to refer cases to Compliance Division for potential fraud.
- Process benefit recovery documents.
- Determine overpayments and underpayments per state processes.
- Prepare benefit recovery claims.
- Refer clients to state financial management unit as appropriate.
- Use state eligibility system to establish recovery amounts for non-fraud cases and notify client via demand letter.
- Initiate recoupment activities.
- Prepare all system overrides and benefit issuances as a result of an under- or over issuance along with other benefit recovery-related cases and refer to the State for authorization.
- Process changes to remove recoupments and refer to State.
- Conduct fraud research and documentation.
- Complete fraud investigations.
- Testify in court upon state request.
- Applies eligibility rules and regulations when evaluating information submitted by customers in support of initial or continuing eligibility determination.
- Checks various system interfaces and exchanges to verify Customer information.
- Attend meetings and trainings as requested and maintains up-to-date knowledge of all programs and systems.
- Contacts customers to clarify eligibility information if necessary.
- Displays excellent communication skills, and an understanding of human behavior to establish an atmosphere in which all contacts are positive.
- May educate customers on basic program services and eligibility requirements.
- Meet Quality Assurance (QA) and other key performance metrics.
- Maintains updated knowledge of project and corporate policies and procedures.
- Ability to identify risk by escalating to management and routing technical issues to the appropriate staff.
- Assist in answering all in-coming phone calls from customers as business needs may warrant.
- Verifying data, reviewing case information, and preparing it for case disposition by the State Eligibility Consultant as business needs may warrant.
- Reprocesses applications, including case repair, and missing information responses in an accurate and timely manner as business needs may warrant.
- Meets all performance requirements associated with eligibility processes.
- Performs other duties as may be assigned by management.
- High school diploma or GED required and 4+ years of relevant professional experience required, or equivalent combination of education and experience.
- Associate degree with 2+ years' experience preferred.
- High school diploma, GED, certification, or equivalent experience required.
- Experience with social services preferred; Indiana Eligibility experience strongly preferred.
- Strong critical thinking and problem-solving skills.
- Works on assignments that are moderately difficult, requiring judgement in resolving issues.
- Understands implications or work and makes recommendations for solutions.
- Accurate data entry skills and the ability to type at least 40 keystrokes/minute.
- Strong interpersonal skills.
- Ability to build positive relationships among customer and state eligibility consultants.
- Attention to detail; excellent organizational, interpersonal, verbal, and written communication skills.
- Ability to perform comfortably in a fast-paced, deadline-oriented work environment.
- Ability to successfully execute many complex tasks simultaneously
- Ability to work as a team member, as well as independently.
- Must be able to remain in a stationary position for an extended period of time.
- Work is constantly performed in an office environment.
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Customer Service Representative - Marion, United States - Maximus Services, LLC
Description
Description & Requirements
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, visitEssential Duties and Responsibilities:
Essential Job Duties and Responsibilities:
Minimum Requirements:
Minimum Required Education:
Background & Experience Required:
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.
