Claim Reviewer

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.