Claims Coordinator: Complex Claims & Rework

EyeMed Vision Care; Mason (OH); On-site; USD 42,000 - 64,000; Full time

Job summary

EyeMed Vision Care in Mason, OH seeks a Full-Time Claims Coordinator to accurately process manual and complex claims, including coordination of benefits, Medically Necessary, resubmitted and EyeRoute claims. The role emphasizes meeting performance KPIs for production, cycle time, and quality.

Requirements include a High School diploma, 3+ years of data entry, and proficiency in Microsoft Office (Outlook, Word, Excel).

Qualifications

• 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.

Responsibilities

• Efficiently and accurately processes complex claims.
• Consistently achieves KPIs with respect to production, cycle time, and quality.
• Participates in claims project initiatives, including rework and/or payment integrity efforts.
• Adapts to process changes from new plans, benefit designs, regulatory changes, etc.
• Collaborates with manager and colleagues to provide strong customer service and communication with key interfaces.
• Maintains clear upward and downward communication to keep team informed.
• Meets or exceeds performance standards in productivity and accuracy.
• Works with supervisor on self-remediation when standards aren’t met.

Skills

Data entry

Communication skills

Customer service

Multi-tasking

Attention to detail

Education

Bachelor's degree

Tools

Facets

Filebound

EyeRoute

Job description

EyeMed Vision Care in Mason, OH seeks a Full-Time Claims Coordinator to accurately process manual and complex claims, including coordination of benefits, Medically Necessary, resubmitted and EyeRoute claims. The role emphasizes meeting performance KPIs for production, cycle time, and quality.

Requirements include a High School diploma, 3+ years of data entry, and proficiency in Microsoft Office (Outlook, Word, Excel).