Vision Claims Processor - Precise Adjudication & Data Entry

EssilorLuxottica; Mason (OH); On-site; USD 36,000 - 52,000; Full time

Job summary

EyeMed, part of EssilorLuxottica, seeks a Claims Processor in Ohio to accurately process vision insurance claims and adjustments while ensuring compliance with plan requirements and HIPAA guidelines.

The role involves reviewing claims for completeness, coordinating with Account Managers and Operations, and supporting provider relations with necessary information for training and adjudication. Strong data-entry skills and knowledge of vision benefits are preferred.

Qualifications

• High School diploma or equivalent work experience.
• 1+ year(s) of data entry experience.
• Claims processing experience is preferred.
• Ability to rapidly grasp new information and concepts.
• Able to multi-task and prioritize issues to meet deadlines.
• Knowledge of Medicare/Medicaid business and strong confidentiality.

Responsibilities

• Efficiently and accurately processes a variety of vision insurance claims or adjustments.
• Determines any special plan requirements prior to billing.
• Reviews claims before entry for completeness and compliance with business requirements.
• Reviews images and transcribed data in the Vidado portal for auto adjudication readiness.
• Participates in special project initiatives and rework as needed.
• Ensures HIPAA compliance and maintains data privacy.

Skills

Attention to detail

Data entry

Multi-tasking

Education

High School diploma or equivalent

Tools

Microsoft Word

Excel

Access

Facets

EyeNet

ExClaim

Job description

EyeMed, part of EssilorLuxottica, seeks a Claims Processor in Ohio to accurately process vision insurance claims and adjustments while ensuring compliance with plan requirements and HIPAA guidelines.

The role involves reviewing claims for completeness, coordinating with Account Managers and Operations, and supporting provider relations with necessary information for training and adjudication. Strong data-entry skills and knowledge of vision benefits are preferred.