Claims Processor
Claims Processor
Posted on :
04-01-2025
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1 Vacancy
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Job Description
2 openings / EYEMED Background check & 5 panel drug screening required before start date. HYBRID 23x in Mason Office. $2000.00 missing equipment fee is assessed if equipment is not returned. Duration: 3/31/2025 Pending Extension Data Entry Test Scores required on Resumes. If not received will decline resume. Budgeted Bill rate: $25.00 (flexible with experience) Hours: MF/FullTime; 84:30 (30Minute lunch)Must have adequate WFH space and follow all Luxottica remote protocol. Characteristics of an ideal candidate: Ability to learn and adopt new processes quickly and with eas Ability to work remotely and autonomously Accustomed to working in a highpaced highvolume environment Strong attention to detail MediumAdvance level of expertise with Microsoft Excel Proficient with Outlook Familiar with Cloudbased applications (i.e. OneDrive) Ability to multitask and perform duties using multiple sources or systems; Data Entry experience preferred Ability to clearly articulate findings issues or concerns requiring resolution Value Prop for Consultant: Provides the employee with exposure to a fastpaced highvolume environment where they are adding value to a department that has maintained 100% client satisfaction 12 years in a row for the nations fastest growing vision care company.Job Description: The ideal candidate will be responsible for the timely and accurate completion of key tasks supporting the successful implementation of new Small Business Clients with and/or on behalf of a team of Implementation Specialists. Responsibilities during this assignment can include: Execute the preliminary steps to build a new client structure for implementation requests routed through shared Salesforce queue; using standard client setup guideline(s) and process(es) Initiation of and accurate and timely tracking for all completed tasks using proprietary Salesforce Implementation Tracker Project Management tool Benefit setup validation in core Facets system and communicating to implementation owners any discrepancies with expected outcome Execution of new client online portal access setup; includes sending the appropriate communication email templates tracking status and reporting any identified issues. Monitor team shared Outlook mailbox for incoming membership documents sent from clients brokers or Third Party Administrators (TPAs) Review incoming membership documents (Microsoft Excel and Word) to confirm accuracy in formatting and validity of data; includes communicating when updates are needed for successful membership enrollment and/or submission for processing. EYEMED ONLY: As part of your contractors compliance while working in the EyeMed department the OIG/GSA/OFAC screening is an additional requirement for EyeMed positions. It should be conducted prior to placement and once a month thereafter. The results should be emailed to by the 4th of each month and we again ask that you house each file internally for auditing purposes. EyeMed needs full screenshots where the website link and the date/time the screening was performed are all visible (this is required for all 3 types of screenings). Screenshots of completed training is required during 1st week of hire. Screenshots are to be kept in file and sent to PMO to upload into IQN. is required during first 2 weeks and completed passport to be sent to manager supplier and ) 3 for Compliance purposes and 4 for HiTrust / Security requirements: 2024 EyeMed General Compliance 2024 EyeMed HIPAA 2024 EyeMed Fraud Waste and Abuse 2024 Conflict of Interests Acknowledgement 2024 Avoiding Dangerous Links 2024 Unintentional Insider Treats FSL New Hire Fraud Integral Staff Training In addition; Model of Care ODAG and CA Fair Claims. Link:
Hours : 8:00am to 5:00pm
Additional Job Details : **LOOKING FOR CANDIDATE WITH A LOT OF EXCEL EXPERIENCEwould love someone with Medicare/Medicaid knowledge as well **PRESCREEN AND DATA ENTRY SCORE REQUIRED****PLEASE ADD DATA ENTRY SCORE AT THE TOP OF THE RESUME** PRESCREEN QUESTIONS NEEDED; Data entry scores must be 9000 ksmp before they can be considered. Anything lower will be declined ** Hours: MF/FullTime; 84:30 (30Minute lunch) HYBRIDE 23x a week. Must be able to come into office for computer pick up and training and if directive is otherwise given. **LOCAL CANDIDATES ONLY Must have adequate WFH space and follow all Luxottica remote protocol. Job Title/Job Description: Claims Processor Budgeted Bill rate: $25.00 Work hours: 85 pm (Full time) Brand: EyeMed Start date: immediately. Length of assignment: Temp to hire or extensions) 5 Panel Drug Screening and Background checks required EYEMED ONLY: As part of your contractors compliance while working in the EyeMed department the OIG/GSA/OFAC screening is an additional requirement for EyeMed positions. It should be conducted prior to placement and once a month thereafter. The results should be emailed to by the 4th of each month and we again ask that you house each file internally for auditing purposes. EyeMed needs full screenshots where the website link and the date/time the screening was performed are all visible (this is required for all 3 types of screenings). Screenshots of completed training is required during 1st week of hire. Screenshots are to be kept in file and sent to PMO to upload into IQN. 3 for Compliance purposes and 4 for HiTrust / Security requirements: 2024 EyeMed General Compliance 2024 EyeMed HIPAA 2024 EyeMed Fraud Waste and Abuse 2024 Conflict of Interests Acknowledgement 2024 Avoiding Dangerous Links 2024 Unintentional Insider Treats FSL New Hire Fraud Integral Staff Training In addition; Model of Care ODAG and CA Fair Claims. Link: is required during first 2 weeks and completed passport to be sent to manager supplier and ) $2000.00 missing equipment fee is assessed if equipment is not returned.
Hours : 8:00am to 5:00pm
Additional Job Details : **LOOKING FOR CANDIDATE WITH A LOT OF EXCEL EXPERIENCEwould love someone with Medicare/Medicaid knowledge as well **PRESCREEN AND DATA ENTRY SCORE REQUIRED****PLEASE ADD DATA ENTRY SCORE AT THE TOP OF THE RESUME** PRESCREEN QUESTIONS NEEDED; Data entry scores must be 9000 ksmp before they can be considered. Anything lower will be declined ** Hours: MF/FullTime; 84:30 (30Minute lunch) HYBRIDE 23x a week. Must be able to come into office for computer pick up and training and if directive is otherwise given. **LOCAL CANDIDATES ONLY Must have adequate WFH space and follow all Luxottica remote protocol. Job Title/Job Description: Claims Processor Budgeted Bill rate: $25.00 Work hours: 85 pm (Full time) Brand: EyeMed Start date: immediately. Length of assignment: Temp to hire or extensions) 5 Panel Drug Screening and Background checks required EYEMED ONLY: As part of your contractors compliance while working in the EyeMed department the OIG/GSA/OFAC screening is an additional requirement for EyeMed positions. It should be conducted prior to placement and once a month thereafter. The results should be emailed to by the 4th of each month and we again ask that you house each file internally for auditing purposes. EyeMed needs full screenshots where the website link and the date/time the screening was performed are all visible (this is required for all 3 types of screenings). Screenshots of completed training is required during 1st week of hire. Screenshots are to be kept in file and sent to PMO to upload into IQN. 3 for Compliance purposes and 4 for HiTrust / Security requirements: 2024 EyeMed General Compliance 2024 EyeMed HIPAA 2024 EyeMed Fraud Waste and Abuse 2024 Conflict of Interests Acknowledgement 2024 Avoiding Dangerous Links 2024 Unintentional Insider Treats FSL New Hire Fraud Integral Staff Training In addition; Model of Care ODAG and CA Fair Claims. Link: is required during first 2 weeks and completed passport to be sent to manager supplier and ) $2000.00 missing equipment fee is assessed if equipment is not returned.
Employment Type
Full Time
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