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Claim Reviewer

Merit

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Remote

Posted 6+ months ago

The Role

As a contracted Claim Reviewer at Merit, you will be part of a team that processes claims for the Ohio Afterschool Child Enrichment (ACE) Educational Savings Program or Kansas KEEP (Kansas Education Enrichment Program). ACE and KEEP provide qualifying families with a $1,000 credit per child. These funds can be used to pay for a variety of educational activities designed to help accelerate learning for children impacted by the COVID-19 pandemic. You will play an active role in confirming the information submitted with the claim is accurate and meets the guidelines for allowable expenses. This role is ideal for an individual who enjoys digging into the details to ensure compliance with a set of provided program guidelines.

Responsibilities

Maintain consistent awareness of program guidelines, claim review procedures, and other operational processes to stay abreast of changes to various practices
Apply the guidelines to each claim with accuracy
Communicate and escalate claims that do not follow program guidelines effectively
Collaborate with team members with the singular goal of processing claims in a timely manner; this will require working across multiple teams

Qualifications

Prior research and/or investigative experience
Exposure/experience with a CRM such as Hubspot, Salesforce, Zendesk, or other
Exposure/experience with either Google Sheets, Excel, or both
Ability to multitask effectively and follow through on tasks
Excellent communication skills, both written and verbal
Ability to efficiently make an assessment based on provided criteria
Highly motivated, values-driven team player with high energy, and enthusiasm

Soft Skills

Active Listening
Attention to detail
Positive Vocabulary
Managing Ambiguity
Creative Problem Solving
Time Management
Follow-up Questioning

At Merit, we don’t just accept differences, we celebrate, support, and value them for the innate benefit of our employees, the competitive advantage of our products, and the strength of the communities we are a part of. Merit is proud to be an equal opportunity workplace. We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity, or veteran status. We encourage applications from veterans and military spouses.

Merit is dedicated to providing an accessible environment for all candidates during the application process and for our employees. If you need accessibility assistance or a reasonable accommodation, you may contact us at talent@gomerits.com.