Vision Claims Specialist: Medicare/Medicaid Adjudication

CTC; Mason (OH); On-site; USD 38,000 - 52,000; Full time

Job summary

CTC in Mason, Ohio is seeking a Claims Coordinator to accurately process vision insurance claims and adjustments, ensuring compliance with plan requirements and quality targets. You will review portal images and transcribed data for auto adjudication, coordinate claim error corrections, and support the Medicare/Medicaid pend process.

The role requires a high school diploma and at least two years of data entry experience; knowledge of Medicare/Medicaid and vision benefits is preferred.

Qualifications

• High School diploma or equivalent required.
• Minimum 2 years of data entry experience.
• Familiarity with Medicare/Medicaid and vision benefits preferred.

Responsibilities

• Efficiently and accurately processes a variety of vision insurance claims or adjustments.
• Effectively and accurately reviews images and transcribed data in the portal in preparation for auto adjudication.
• Coordinate and complete claim error corrections
• Maintains the Medicare/Medicaid Pend Claims process
• Understands and quickly operationalizes processing changes resulting from new plans, benefit designs.
• Works with supervisor and co-workers to provide strong customer service and communication with key customer interfaces that include Account Managers, Operations, Information Systems, Client Representatives and leadership team

Skills

Data entry

Education

High School diploma or equivalent

Tools

Microsoft Word

Excel

Access

Job description

CTC in Mason, Ohio is seeking a Claims Coordinator to accurately process vision insurance claims and adjustments, ensuring compliance with plan requirements and quality targets. You will review portal images and transcribed data for auto adjudication, coordinate claim error corrections, and support the Medicare/Medicaid pend process.

The role requires a high school diploma and at least two years of data entry experience; knowledge of Medicare/Medicaid and vision benefits is preferred.