Claims Coordinator

Job Details :

Description / Comment :

BACKFILL ACTUAL JOB TITLE : Claims Coordinator

Work hours : 8 - 5pm with hour lunch, or 8-430 with 30 minute lunch.

Brand : Eyemed

Temp only position

Start date : ASAP

Length of assignment : 12 / 31 / 2025

Location Address : 4000 LUXOTTICA PL MASON OH 45040

Onsite 5 days a week for first few months will be workplace only with possible hybrid opportunity with 3 days office and 2 days remote - possible not guaranteed

REASON FOR REQUEST : Temporary Resource to support a Medically Necessary Contacts Processing

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 :

EXPERIENCE :

EDUCATION : High school mandatory

There will actually be 5 courses that required for all temporary employees :

3 for Compliance purposes and 2 for HiTrust / Security requirements :

1. General Compliance

2. HIPAA

3. Fraud, Waste, and Abuse

4. Security Essentials

5. Introduction to Phishing

In addition; Model of Care, ODAG, FSL Fraud Integral Staff training, CA Fair Claims.

Start Time : 12 : 00 AM

Hours : 8 : 00am to 5 : 00pm

Location :

CINCINNATI SERVICE CENTER 4000 LUXOTTICA PL MASON OH 45040

Education :

Additional Job Details :

EYEMED ONLY : As part of your contractor's 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 LUXOTTICATEMPS@kellyocg.com 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. Eyemed Mandatory Training (3 for Compliance purposes and 4 for HiTrust / Security requirements) is required during first 3 weeks and completed passport to be sent to manager, supplier and Contatti@luxotticaretail.com)