Job Summary

The Benefit Audit Agent is responsible for reviewing unemployment insurance claims against wages earned to determine if benefits were appropriately collected. Using critical thinking skills, the Agent will analyze all information, notes, and documentation against State and Federal policy and determine what additional information is needed to validate appropriate claim payments. They will then perform outreach to employers to obtain the necessary information, notate that in the claim file, and forward detailed notes as required to resolve the issue.

The position requires using time management to work a caseload effectively and in order of priority set by leadership, critical thinking skills to identify the needs on each unique claim, and communication skills ensuring that information gathered is clearly notated in the claim.

Job Duties

Benefit Audit Agents will perform job duties such as:

• Analyzing claim information to identify discrepancies or missing information
• Assessing the information against requirements based on UI Code, Policies, and Procedures
• Sending employers standard forms to obtain additional information or clear up a discrepancy
• Working closely with subject matter experts to gain further understanding of how to address outstanding issues or identify when a claim needs to be escalated
• Reviewing and resolving complex issues referred by other front line staff
• Reviewing wage and income information, benefits payments, and cross-matching to determine if payments were made appropriately
• Notating all actions taken on a claim clearly and thoroughly
• All other duties as assigned by management to support claim processing

Experience & Qualifications

• 3-5 years’ experience in claim or case audits
• Hired candidates must bring own device, technological requirements to be provided.
• Must be available to work full-time, from home, Monday through Friday 8am to 5pm, Pacific Time.
• Position also requires fingerprinting in a timely manner.

· Proficient technical writing skills to support detailed case notes

· Demonstrating the ability to make logical decisions

· Demonstrating the ability to manage a workload in a way that meets timeliness requirements

· Critical thinking & time management skills

· Strong computer skills to facilitate the navigation of multiple systems

· Background working in insurance or case management is highly desirable

As a leading strategic partner to governments across the globe, Maximus helps improve the delivery of public services amid complex technology, health, economic, environmental, and social challenges. With a deep understanding of program service delivery, acute insights that achieve operational excellence, and an extensive awareness of the needs of the people being served, our employees advance the critical missions of our partners. Maximus delivers innovative business process management, impactful consulting services, and technology solutions that provide improved outcomes for the public and higher levels of productivity and efficiency of government-sponsored programs.