Claims Processor
About The Position
Accurately and efficiently processes manual claims and other simple processes such as claims projects. Through demonstrated experience and knowledge, process standard, non-complex claims requiring a basic knowledge of claims adjudication. This is a hybrid role requiring 2-3 days per week in the Mason Office. Candidates must have adequate WFH space and follow all Luxottica remote protocol. A $2,000.00 missing equipment fee is assessed if equipment is not returned. Background check & 5-panel drug screening required before start date. Data Entry Test Scores are required on resumes; if not received, the resume will be declined. There are 5 mandatory courses for all temporary employees: 3 for Compliance (General Compliance, HIPAA, Fraud, Waste, and Abuse) and 2 for HiTrust/Security requirements (Security Essentials, Introduction to Phishing).
Requirements
- Data entry and claims processing knowledge
- Working knowledge of interface systems that include the EyeMed claims system, Metastorm, Exclaim and EyeNet
- Some basic working knowledge of software programs, specifically Excel and Access
- Understands third party benefits and administration
- Strong customer service focus
- Ability to work well under pressure and multi-task
- 0-1 years of claims processing/data entry experience.
- Knowledge of PCs and spreadsheet applications
- High school mandatory
Responsibilities
- Efficiently and accurately processes standard claims or adjustments
- Consistently achieves key internals with respect to production, cycle time, and quality
- May participate on non-complex special claims projects initiatives, including network efforts
- Understands and quickly operationalizes processing changes resulting from new plans, benefit designs.
- Works with supervisor and co-workers to provide strong customer service and communication with key customer interfaces that include EyeMed Account Managers, Operations, Information Systems, Client Representatives and EyeMed leadership team
- Consistently meets or exceeds agreed upon performance standards in both productivity and accuracy
- Proactively works with supervisor to develop self-remediation plan when standards are not being met
Benefits
- Paid when paid
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
