Office​/Administration - Claims Processor

Job-ID Reference
26-26128
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 Eye Med Account Managers, Operations, Information Systems, Client Representatives and Eye Med 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 Eye Med claims system, Metastorm, Exclaim and Eye Net

• 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
EEO:
“Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of – Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.”