Coordinator- Claims

Requisition ID: 944725 | Store #: 110365 | Position: Full-Time

This posting is for an existing vacancy within our business.

About the role

At EyeMed, we have a unique perspective on vision benefits. By listening and staying curious, we create innovative vision benefits that are a joy to use. Our mission is to help people see life to the fullest—and our commitment goes beyond vision benefits. Our passionate employees proudly support the OneSight EssilorLuxottica Foundation, a leading not-for-profit organization with a 100% focus on eradicating the world’s vision crisis. EyeMed is part of EssilorLuxottica, a global leader in the design, manufacture and distribution of world-class vision care products, including iconic eyewear, advanced lens technology and cutting-edge digital solutions. Join our global community of over 200,000 dedicated employees around the world in driving the transformation of the eyewear and eyecare industry. Discover more by following us on LinkedIn.

Responsibilities

• The Claims Coordinator will accurately and efficiently process all types of manual claims.
• Process complex claims, which includes coordination of benefits claims, Medically Necessary claims, resubmitted claims, EyeRoute claims, standard adjustments, VIP claims, complex manual workaround processes, claims rework projects, and daily reporting processes while ensuring key deliverables are met.
• Efficiently and accurately processes complex claims
• Consistently achieves key performance indicators with respect to production, cycle time, and quality
• Participates on claims project initiatives, including rework and/or payment integrity efforts
• Understands and quickly operationalizes process changes resulting from new plans, benefit designs, regulatory changes, etc.
• Works with manager and co-workers to provide strong customer service and communication with key customer interfaces that include: EyeMed Account Managers, Operations, IT, Client Representatives and EyeMed leadership team
• Frequent communication with internal associates and claims management. Ensure upward and downward communication to keep management and team members properly informed.
• 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.

Requirements

• High School diploma or equivalent work experience
• 3+ year(s) of data entry experience
• Knowledge and experience in Microsoft Office Products (Outlook, Word, Excel)
• Ability to work well under pressure and multi-task
• Flexibility working in both a team and individual environments
• Ability to quickly grasp and retain information and concepts

Preferred Qualifications

• Bachelor