Vision Claims Supervisor - Medicaid/Medicare Expert

Benecard Services, LLC; Clifton (NJ); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Vacation and Sick Time

Medical Insurance

Vision Insurance

Dental Insurance

Life Insurance

Disability Insurance

Tuition Reimbursement

Professional Development Training

Job summary

National Vision Administrators seeks an experienced Claims Supervisor to oversee daily operations of the vision eye care claims team, ensuring Medicaid and Medicare adjudication is accurate and timely while complying with regulatory standards. This in-office role is based in Clifton, New Jersey, with Monday–Friday hours 8:30am–5:00pm.

You will supervise staff, review high‑dollar claims, and drive quality assurance and audits.

Qualifications

• 3+ years of Medicaid/Medicare claims processing and adjudication experience.
• Prior experience in vision plans, optometry, ophthalmology, or eye care billing.
• Knowledge of CMS-1500 forms and electronic billing.
• Timely filing, resubmissions, appeals, and remittance advice.
• Experience with COB/TPL and denied claims resolution.
• Familiarity with AS400 or similar claims systems.
• Strong Excel and Microsoft Office skills.
• Excellent communication and organizational skills.
• CPC, CPB, or CBC certification preferred.

Responsibilities

• Supervise claims staff and manage daily workflow.
• Review and process complex and high-dollar claims.
• Ensure accuracy of medical billing and coding (CPT, ICD-10, HCPCS, modifiers).
• Manage COB/TPL claims and resolve denials/rejections.
• Ensure Prompt Pay compliance and regulatory adherence.
• Oversee ManageEngine tickets and escalations.
• Support audits, reporting, and quality assurance initiatives.
• Train and develop team members.

Skills

Medicaid/Medicare processing

Vision plans billing

Excel

Communication

Organizational skills

COB/TPL

AS400

Claims systems

CPC/CPB/CBC certification

Tools

AS400

ManageEngine

Claims systems

Job description

National Vision Administrators seeks an experienced Claims Supervisor to oversee daily operations of the vision eye care claims team, ensuring Medicaid and Medicare adjudication is accurate and timely while complying with regulatory standards. This in-office role is based in Clifton, New Jersey, with Monday–Friday hours 8:30am–5:00pm.

You will supervise staff, review high‑dollar claims, and drive quality assurance and audits.