Office/Administration - Claims Processor

Real Soft • Mason, OH

2d • Hybrid

About The Position

The Claims Processor accurately and efficiently processes manual, standard, non-complex claims and adjustments, as well as other simple processes and claims projects. The role requires a basic knowledge of claims adjudication and the ability to maintain production, cycle-time, and quality standards. The position may also support non-complex claims initiatives, including network efforts, and implement processing changes resulting from new plans and benefit designs.

This is a temporary assignment with possible extensions and potential conversion to a full-time associate role. The position is based in Mason, Ohio, and follows a hybrid schedule requiring work in the Mason office two to three times per week. The stated schedule is Monday through Friday, 8:00 a.m. to 4:30 p.m., with a 30-minute lunch. Remote work requires adequate workspace and compliance with Luxottica remote-work protocols. Data-entry test scores must be included on submitted resumes.

Requirements

• Zero to one year of claims-processing or data-entry experience.
• Knowledge of data entry and claims processing.
• Knowledge of PCs and spreadsheet applications.
• Working knowledge of interface systems including the EyeMed claims system, Metastorm, Exclaim, and EyeNet.
• Basic working knowledge of Excel and Access.
• Understanding of third-party benefits and administration.
• Strong customer-service focus.
• Ability to work well under pressure and multitask.
• Data-entry test scores must be provided on the resume.
• OIG/GSA/OFAC exclusion screenings must be completed before placement or start; EyeMed contractors must also be screened monthly by the fourth of each month.
• Must have adequate work-from-home space and follow Luxottica remote-work protocols.

Responsibilities

• Accurately and efficiently process standard claims and adjustments.
• Meet production, cycle-time, and quality targets.
• Participate in non-complex special claims projects and initiatives, including network efforts.
• Understand and implement processing changes resulting from new plans and benefit designs.
• Work with the supervisor and coworkers to provide strong customer service and communicate with EyeMed Account Managers, Operations, Information Systems, Client Representatives, and EyeMed leadership.
• Meet or exceed agreed-upon productivity and accuracy performance standards.
• Work proactively with the supervisor to develop a self-remediation plan when performance standards are not being met.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: No Education Listed