Specialist Provider Relations (Assignment)

Requisition ID: 879992

Store #: 110351 EM Assignment Claims - OH CSC

Position:Full-Time

Total Rewards: Benefits/Incentive Information

At EyeMed, we have a unique perspective on vision benefits. By listening and staying curious, we create innovative vision benefits that are a joy to use.

Our mission is to help people see life to the fullest—and our commitment goes beyond vision benefits. Our passionate employees proudly support the OneSight EssilorLuxottica Foundation, a leading not-for-profit organization with a 100% focus on eradicating the world’s vision crisis.

EyeMed is part of EssilorLuxottica, a global leader in the design, manufacture and distribution of world-class vision care products, including iconic eyewear, advanced lens technology and cutting-edge digital solutions. Join our global community of over 200,000 dedicated employees around the world in driving the transformation of the eyewear and eyecare industry. Discover more by following us on LinkedIn.

GENERAL FUNCTION

The Specialist – Provider Relations will support all activities for the set up and maintenance of retail stores and providers on the Assignment networks. The Specialist will ensure all stores and providers are set up accurately and maintained in our internal database. The Specialist will also support provider / store education and resolution of escalated issues. Specialist will collaborate with various internal and external business partners to track, report, and identify opportunities that create simplicity and drive business initiatives while maintaining compliance with corporate guidelines, and ensuring ongoing alignment with performance metrics.

Major Duties And Responsibilities

• Support new store & provider data to track, maintain, and update new store set-up. Communicating with the retail brands and the fleet management team to ensure data is accurate to support smooth openings for retail stores.
• Create and distribute bi-weekly provider rosters to insurance carriers to ensure store locations and affiliated providers are added to the appropriate networks accurately and on time.
• Support new store-activity tracker, brand reference sheets, and updated information all communicated timely to the brands.
• Interact with providers to answer credentialing questions, payment withhold disputes, payment questions and escalated issues
• Maintain strong relationship with carriers, retail stores and the Assignment Call Center, resolving escalated member concerns, credentialing issues, plan benefit clarification and claim research
• Participate in cross-functional projects, representing the provider relations sphere of activity as related to provider set up in our systems.
• Special Projects as assigned
  
  

Basic Qualifications

• Bachelor's Degree in a related field or equivalent work experience
• 3 year of experience in operations type role
• Strong Excel Skills
• Excellent interpersonal, oral, and written communication skills
• Strong problem-solving, analysis and issue resolution skills
• Ability to work independently in a fast-paced environment, manage multiple assignments, establish priorities, and demonstrate excellent time management skills
• Demonstrate thorough critical thinking skills to solidify understanding of bigger picture
• Strong attention to detail
• Self-driven desire to drive initiatives
  
  

Preferred Qualifications

• Experience in provider relations, contract / provider onboarding, & credentialing
• Experience in Facets
  
  

Employee pay is determined by multiple factors, including geography, experience, qualifications, skills and local minimum wage requirements. In addition, you may also be offered a competitive bonus and/or commission plan, which complements a first-class total rewards package. Benefits may include health care, retirement savings, paid time off/vacation, and various employee discounts.

Upon request and consistent with applicable laws, EssilorLuxottica will provide reasonable accommodations to individuals with disabilities who need assistance in the application and hiring process.  To request a reasonable accommodation, please call the EssilorLuxottica SpeakUp Hotline at 844-303-0229 (be sure to provide your name and contact information so that we may follow up in a timely manner) or email HRCompliance@luxotticaretail.com.

We are an Equal Opportunity Employer.  All qualified applicants will receive consideration for employment without regard to race, color, gender, national origin, social origin, social condition, being perceived as a victim of domestic violence, sexual aggression or stalking, religion, age, disability, sexual orientation, gender identity or expression, citizenship, ancestry, veteran or military status, marital status, pregnancy (including unlawful discrimination on the basis of a legally protected pregnancy or maternity leave), genetic information or any other characteristics protected by law. Native Americans in the US receive preference in accordance with Tribal Law.