Claims Processor

Claims ProcessorPosition Title: Claims Processor/ONSITE Location: 4000 LUXOTTICA PL Mason OH 45040 Work Hours: 9 - 5pm Pay Rate: $ 22.55/hr on W2 Paid Weekly!

Benefits: Paid weekly, health, dental + vision insurance available! Preferred Start Date: 9/28/2026 Duration: 3month(s)/ Extension is possible based on performance, attendance, and business needSpecific Skills Needed: Top 3-5 mandatory and/or minimum requirements: see JD attached Top 3-5 desirable attributes/qualifications?: see JD attachedGeneral Function: The Claims Coordinator accurately and efficiently processes all types of claims from source documents, maintaining compliance with the insurance plan requirements and with high regard for adhering to goals for quality and claims production rates. Also performs other complex claim processing which include but not limited to Medicare/Medicaid Pend process, Corrected Claims, and running daily reports.Major Duties and Responsibilities:Efficiently and accurately processes a variety of vision insurance claims or adjustments.Determines any special plan requirements prior to billing.Reviews claims before entry for completeness and compliance with business requirements.Effectively and accurately reviews images and transcribed data in the portal in preparation for auto adjudication.Coordinate and complete claim error correctionsMaintains the Medicare/Medicaid Pend Claims processParticipates on special project initiatives, including rework efforts as needed.Understands and quickly operationalizes processing changes resulting from new plans, benefit designs.Maintains compliance with HIPAA guidelines and regulations.Works with supervisor and co-workers to provide strong customer service and communication with key customer interfaces that include Account Managers, Operations, Information Systems, Client Representatives and leadership team.Assists Team Lead in a backup lead capacityAssists with root cause analysis of claim issues to resolve thoroughly and completely for clientsContacts stores or providers (when necessary) to obtain additional information or follow up on claims.Basic Qualifications:High School diploma or equivalent work experience3+ year(s) of data entry experienceStrong customer service focusStrong verbal & written communication skillsAble to multi-task and prioritize issuesStrong attention to detailsPreferred Qualifications:Knowledge of Medicare/Medicaid businessKnowledge of vision benefits and/or insurance industryProficient in Microsoft Word, Excel and Access