What are the responsibilities and job description for the Claims Processor position at ReqCareer Solutions?
ACTUAL JOB TITLE: Claims Coordinator
Work hours: 8 - 5pm with hour lunch, or 8-430 with 30 minute lunch.
Bill Rate: $25.00
Start date: ASAP Length of assignment: 52 weeks – 12/31/2025
Location Address: MASON OH 45040 Onsite 5 days a week for first few months will be workplace only with possible hybrid opportunity with 3 days office and 2 days remote - possible not guaranteed
REASON FOR REQUEST:
Temporary Resource to support a Medically Necessary Contacts Processing
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 There will actually be 5 courses that required for all temporary employees: 3 for Compliance purposes and 2 for HiTrust / Security requirements:
1. General Compliance
2. HIPAA
3. Fraud, Waste, and Abuse 4. Security Essentials 5. Introduction to Phishing In addition; Model of Care, ODAG, FSL Fraud Integral Staff training, CA Fair Claims.
Hours : 8:00am to 5:00pm
Job Type: Contract
Pay: $16.00 - $17.00 per hour
Expected hours: 40 per week
Schedule:
- Monday to Friday
Work Location: In person
Salary : $16 - $17
