Description & Requirements
Maximus is currently hiring for a Provider Reimbursements Representative to join our Veterans Evaluation Services (VES) team. This is a remote opportunity. The Provider Reimbursements Representative is responsible for working closely with providers to establish good rapport and to answer their inquiries with regard to DBQs, travel pay, contractual agreements, and pay rates. They will issue bonus requests, rate increases and other fees as required as well as follow up on reports that are pending signature.
Essential Duties and Responsibilities: - Provider Reimbursements must be well versed in VES contracts and able to explain and negotiate contracts with our providers; - Negotiates rates with our provider network; Reimbursements should be able to assess a number of factors when considering rates, including provider timeliness, report quality, history with the company, and any outlying circumstances; - Negotiates provider bonuses as applicable and issues bonus requests; when considering bonuses, Reimbursements team should be able to assess a variety of factors, including the size and approximate difficulty of a given case, any differences in regional pricing which may factor in, and any prior payment agreements which we may have with the provider; - Reimburses travel expenses for VES related work and conveys VES policies re: travel to providers; Provider Reimbursements should communicate with Regional Operations Managers and scheduling leadership to assess VES' needs which necessitated travel and to discuss any other challenges related to provider travel. - Explains in detail our provider contracts and billing procedures as needed; - Assists Billing team with provider inquiries into past payments; - Assists Accounting by answering provider questions on 1099s and tax issues, and with dispersal of 1099s as needed; Additional Duties and Responsibilities: - Assist providers with any and all questions related to payment; - Reliably route providers to the proper department or person when assisting with non- payment related issues; - Attend biweekly team meetings; - Other duties as assigned by management; Knowledge/Skills/Abilities: - Self- starter; - Intermediate knowledge of pertinent medical terminology; - Advanced verbal and interpersonal skills; - Advanced written communication skills, to include excellent grammar; - Advanced reading and comprehension abilities; - Advanced analytical skills and detail- oriented; - Advanced multi- tasking skills; - Advanced organizational and prioritization skills, with strong ability to meet strict deadlines with minimal supervision; - Proficient typing skills; and - Proficient with Microsoft Word, Microsoft Outlook, Adobe Acrobat, general internet research, and beginner knowledge of Microsoft Excel. Working Conditions: - Casual office environment, with some exposure to mild noise from office equipment and moderate noise generated by staff members; and - Frequently utilizes phone, fax machine, computer, printer, and copy machines.
Minimum Requirements
Minimum Qualifications: - Bachelor's degree or equivalent experience required;
- Billing or finance experience highly preferred
- Intermediate knowledge of Excel and Outlook preferred
- QA experience preferred
- Ability to work a training schedule of 8am-4:30pm CT Monday - Friday required
- Ability to work a schedule within 7am-6pm CT Monday - Friday required
Please note: With this position you have the option to have Maximus provide you with equipment to use, or you may use your own equipment.
Home Office Requirement s Using Your Own Equipment :
- Internet speed of 20mbps or higher required (you can test this by going to )
- Preferred Windows or Mac (no Chromebooks)
- OS for Windows - Windows 10 or newer
- OS for Mac - Big Sur (11.0.1+); Catalina (10.15); M acOS (up to 12.5) or newer
- Connectivity to the internet via either Wi-Fi or Category 5 or 6 ethernet patch cable to the home router
- USB plug and play wired headset with a microphone and noise suppression
- Private work area and adequate power source
- A second monitor is highly recommended for most positions
- Must currently and permanently reside in the Continental US
Home Office Requirements Using Maximus-Provided Equipment:
- Internet speed of 20mbps or higher required (you can test this by going to )
- Connectivity to the internet via either Wi-Fi or Category 5 or 6 ethernet patch cable to the home router
- Private work area and adequate power source
- Must currently and permanently reside in the Continental US
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.
