Office/Administration - Claims Processor

Cynet Systems • Mason, OH

3d • Hybrid

About The Position

The Claims Processor accurately and efficiently processes manual, standard, non-complex claims, adjustments, and other simple processes such as claims projects. The role requires a basic knowledge of claims adjudication and the ability to operationalize processing changes resulting from new plans and benefit designs. The position is based in Mason, Ohio, and is hybrid, with work in the Mason office two to three times per week and remote work subject to the client’s protocols and an adequate work-from-home space. The schedule is Monday through Friday, 8:00 a.m. to 4:30 p.m., with a 30-minute lunch. The assignment is temporary and pending extensions; conversion to a full-time associate may be possible. Applicants must include data entry test scores on their resumes or the resume will be declined. OIG/GSA/OFAC exclusion screenings are required before placement or start and monthly thereafter for EyeMed contractors. A $2,000 missing-equipment fee is assessed if equipment is not returned.

Requirements

• 0–1 years of claims processing or data entry experience.
• Knowledge of PCs and spreadsheet applications.
• Data entry and claims processing knowledge.
• Working knowledge of 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 included on the resume.
• Adequate work-from-home space and compliance with client remote-work protocols.
• OIG/GSA/OFAC exclusion screenings are mandatory.

Responsibilities

• Efficiently and accurately process standard claims and adjustments.
• Meet production, cycle-time, and quality targets.
• Participate in non-complex special claims project initiatives, including network efforts, as needed.
• Understand and quickly implement processing changes resulting from new plans and benefit designs.
• Work with the supervisor and coworkers to provide strong customer service and communication to EyeMed Account Managers, Operations, Information Systems, Client Representatives, and the EyeMed leadership team.
• Meet or exceed agreed-upon productivity and accuracy standards.
• Work proactively with the supervisor to develop a self-remediation plan when performance standards are not met.
• Complete required OIG/GSA/OFAC screenings before placement or start and monthly thereafter during the EyeMed assignment.

What This Job Offers

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