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Claims Processor

Mindlane
Mason, OH Full Time
POSTED ON 4/3/2025
AVAILABLE BEFORE 6/3/2025

Claims Processor

Location : Mason, Ohio, 45040

Work hours: 8 - 5pm with hour lunch, or 8-4.30 with 30 minute lunch.

8 months contract to begin with, possibilities of extension according to performance.

Onsite for first few months will be workplace only with possible hybrid opportunity with 3 days office and 2 days remote - possible not guaranteed



GENERAL FUNCTION:

Accurately and efficiently processes manual claims and other simple processes such as claims projects. Through demonstrated experience and knowledge, process standard, non-complex claims requiring a basic knowledge of claims adjudication.

MAJOR DUTIES & RESPONSIBILITIES:

Processing - Efficiently and accurately processes standard claims or adjustments

Consistently achieves key internals with respect to production, cycle time, and quality

May participate on non-complex special claims projects initiatives, including network efforts

Understands and quickly operationalizes processing changes resulting from new plans, benefit designs.

Drive client satisfaction - Works with supervisor and co-workers to provide strong customer service and communication with key customer interfaces that include EyeMed Account Managers, Operations, Information Systems, Client Representatives and EyeMed leadership team

Drives Key Performance Indications - Consistently meets or exceeds agreed upon performance standards in both productivity and accuracy

Proactively works with supervisor to develop self-remediation plan when standards are not being met

KNOWLEDGE & SKILLS:

Data entry and claims processing knowledge

Has a working knowledge of interface systems that include the EyeMed claims system, Metastorm, Exclaim and EyeNet

Some basic working knowledge of software programs, specifically Excel and Access

Understands third party benefits and administration

Strong customer service focus

Ability to work well under pressure and multi-task

EXPERIENCE:

0-1 years of claims processing/data entry experience. Knowledge of PCs and spreadsheet applications

EDUCATION: High school mandatory

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