Claims Coordinator

Claims Coordinator

Vision Associates is the nation's leading optical dispensary management & consulting company. Our mission is to provide the highest level of service and integrity. Our extensive background in the optical industry enables us to provide solutions that promote growth and profitability. In partnership with our clients, our foremost objective is to deliver complete and comprehensive service that reflects our commitment to eye care excellence.

Everyday we feel inspired to ignite our passion for patient care. Our people work closely with doctors, learn from complex medical cases, and make a difference in patients' lives. We unleash the power of optical.

Vision Associates 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.

General Function

The Claims Coordinator will accurately and efficiently process all types of manual claims. The Coordinator will process complex claims, which includes coordination of benefits claims, Medically Necessary claims, resubmitted claims, EyeRoute claims, standard adjustments, VIP claims, complex manual workaround processes, claims rework projects, and daily reporting processes while ensuring key deliverables are met.

Major Duties and Responsibilities

• Efficiently and accurately processes complex claims
• Consistently achieves key performance indicators with respect to production, cycle time, and quality
• Participates on claims project initiatives, including rework and / or payment integrity efforts
• Understands and quickly operationalizes process changes resulting from new plans, benefit designs, regulatory changes, etc.
• Works with manager and co-workers to provide strong customer service and communication with key customer interfaces that include : EyeMed Account Managers, Operations, IT, Client Representatives and EyeMed leadership team
• Frequent communication with internal associates and claims management. Ensure upward and downward communication to keep management and team members properly informed.
• 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.

Basic Qualifications

Preferred Qualifications

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.

EssilorLuxottica complies with all applicable laws related to the application and hiring process. 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.