Claims Processor

Job TitleGENERAL 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 adjustmentsConsistently achieves key internals with respect to production, cycle time, and qualityMay participate on non-complex special claims projects initiatives, including network effortsUnderstands 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 teamDrives Key Performance Indications - Consistently meets or exceeds agreed upon performance standards in both productivity and accuracyProactively works with supervisor to develop self-remediation plan when standards are not being metKNOWLEDGE & SKILLS:Data entry and claims processing knowledgeHas a working knowledge of interface systems that include the EyeMed claims system, Metastorm, Exclaim and EyeNetSome basic working knowledge of software programs, specifically Excel and AccessUnderstands third party benefits and administrationStrong customer service focusAbility to work well under pressure and multi-taskEXPERIENCE:0-1 years of claims processing/data entry experience.