Office/Administration - Claims Processor

CLAIMS PROCESSOR

Budgeted Bill rate: $30.00 MARKUP 33.05% / Tenure discount 13 months 22.50% Payment Terms - Net 90 (paid when paid) OIG/GSA and Background screenings required A $ 2,000.00 missing equipment fee is assessed if equipment is not returned. Brand - EYEMED Location: Mason, OH - 4000 Luxottica Place Hours: M-F/Full-Time; 8-4:30 (30-Minute lunch) Must have adequate WFH space and follow all Luxottica remote protocols. HYBRID - 2-3x in Mason Office. Duration: Temp pending extensions (candidate could convert to a full time assoicate) Data Entry Test Scores required on Resumes. If not received, the resume will be declined. GENERAL FUNCTION: 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.

MAJOR DUTIES & RESPONSIBILITIES:

• Processing - 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.
• Drive client satisfaction - 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
• Drives Key Performance Indications - 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

KNOWLEDGE & SKILLS:

• Data entry and claims processing knowledge
• Has a 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

EXPERIENCE:

0-1 years of claims processing/data entry experience. Knowledge of PCs and spreadsheet applications Effective immediately, OIG/GSA/OFAC Exclusion Screenings are now a mandatory requirement for all contractors supporting any brand or subsidiary of EssilorLuxottica and Eyemed. Please review the updated guidelines below and attached work instructions:

• All Positions: OIG/GSA/OFAC screenings must be completed prior to placement/start date.
• Eyemed Contractors: Screenings must also be conducted monthly thereafter, by the 4th of each month, for the duration of the assignment.
• Submission: Please send all completed screening screenshots to View email address on click.appcast.io with the subject line "OIG/GSA Screenings."

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