|Reference # : ||17-05858
||Title : ||Claims Processor|
|Experience Level : ||
||Start Date / End Date : ||09/25/2017 / 12/24/2017
| Description |
||REPLACEMENT REQUEST -
GENERAL FUNCTION: Accurately and efficiently processes manual claims and other simple processes such as matrix and bypass. Through demonstrated experience and knowledge, process standard, non-complex claims requiring a basic knowledge of claims adjudication.
MAJOR DUTIES AND 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 AND 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
? Entry level experience in claims processing/data entry experience
? Knowledge of PCs and spreadsheet applications
EDUCATION: High school mandatory
||7:30am ? 4:00pm
||CINCINNATI SERVICE CENTER 4000 LUXOTTICA PL MASON OH 45040
|Additional Job Details:
||REPLACEMENT REQUEST - JOB DESCRIPTION : Claims Processor for the Claims Network Processing Team HOURS: Full time, 40 hours SCHEDULE: Flexible 8 hrs (anytime between 7 am to 5 pm.) BRAND: Eyemed START DATE: ASAP LENGTH OF ASSIGNMENT: 12/31/17 SUBMITTAL REQUIREMENTS: Data Entry scores of 8,000+ kspm are required. MUST SUBMIT 10 KEY assessment scores and alpha numeric assessment scores!! TRAINING HOURS - 7:30am - 4:00pm **** Must be comfortable with sitting at a desk for 8 hours a day ******* Candidates that are chosen for interviews will be able to shadow briefly to get an idea of the position they would be involved in. SCHEDULING INTERVIEWS: Lux is available for interviews during the following time frames - When submitting candidates for review, please be sure to include their availability to interview in the following time spots: Monday, Tuesday, & Thursday between 10am-2pm work best for us. **ONLY SUBMIT CANDIDATES THAT CAN CONVERT AFTER 90 DAYS WITHOUT A FEE** **Criminal checks and drug screenings results must be received before a person can start work in Claims. *EYEMED ONLY: Since your contractor will be working in the EyeMed department, the OIG/GSA scan is an additional requirement for EyeMed positions. It should be conducted prior to placement and once a month thereafter.