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Claims Sr Analyst Testing

Date:  Feb 20, 2021
Brand:  EyeMed Vision Care
Location: 

Mason, OH, US, 45040

Requisition ID: 297244 
Position:Full-Time

 

There’s more to EyeMed than meets the eye. EyeMed is the fastest growing managed vision benefits company in the country with consistent double-digit membership growth! Through our commitment to innovation, we’re reimagining the way employers and their employees think about vision care. We want them to see life to the fullest and experience more of what’s best, not more of the same.  And if what’s best hasn’t been done yet, it’s our exceptional and passionate employees driving this change. But, our passion for vision isn’t just about vision insurance benefits. Our employees are proud to support and participate in life-altering global and local missions through our partnership with OneSight, a leading not-for-profit organization with a 100% focus on eradicating the world’s vision crisis.

 

Your family says a lot about who you are. EyeMed is a key member of the Luxottica family of companies, global leaders in the design, manufacture and distribution of fashion, luxury and sports eyewear.  In North America, Luxottica is the home to global brands Ray-Ban, Oakley and many top fashion house brands.  Our leading retail brands include LensCrafters, Sunglass Hut, Pearle Vision, Target Optical and Sears Optical.

 

If you’re passionate about driving innovation and change and interested in a career in the optical and insurance industry, EyeMed wants to start the conversation and help provide you a growth-focused opportunity with America’s fastest growing vision benefits company.

GENERAL FUNCTION

The Sr Analyst – Claims is responsible for claims validation for client testing requests, new client implementations and system stability testing. The Sr Analyst is the liaison to Claims Testing Manager, Director Claims & Payments and other internal customers to identify claims processing discrepancies due to system setup issues that require cross functional partnership and retesting.   

 

MAJOR DUTIES AND RESPONSIBILITIES

  • Collaborate and partner with cross functional departments to define testing scope and prioritization of testing requests.
  • Completes testing and issue resolution processes including cross-functional communication and IT partnership to identify concerns, create action plans to solve and ensure testing is meeting the needs of our constituents (plans, members and providers).
  • Develop and maintain testing scenario scripts.
  • Partner cross functionally to ensure system is ready for testing scenarios to be input.
  • Validate the integrity of claims data in the EyeMed claims and payments UAT systems.
  • Track all testing defects and the status of the defect resolution through re-testing.
  • Partner with IT and other departments to identify system changes/tickets that may need entered into the system.
  • Conduct End to End testing, Be the Constituent testing, and Pre-Implementation testing.
  • Analyze and document clear and concise testing results so there is a smooth transition to EyeMed’s claims and payments production systems.
  • Maintain effective, on-going communication with Claims Testing Manager and other key departments.
  • Understand the process flow of systems, how the systems interact and the logic behind file requirements (SAP, ODS and Facets / EOBs/RAs)
  • Identify opportunities for improvement related to the testing process and best practices. Sees these opportunities through implementation.
  • Report any potential risks to the Claims Testing Manager related to testing.

 

BASIC QUALIFICATIONS

  • Bachelor's Degree or equivalent work experience
  • 3+ years of process management experience
  • Knowledge of Microsoft Office applications
  • Working knowledge of Facets, SAP, Business Objects
  • Strong communication, problem solving, teamwork and organization skills
  • Strong analytical skills and critical thinking
  • Ability to work cross functionally
  • Ability to multitask and manage project timelines

 

PREFERRED QUALIFICATIONS

  • Bachelor's Degree in IT related field or Analytics
  • At least 5+ years of analysis experience
  • Knowledge of SQL
  • Highly motivated self-starter
  • 5+ years of process management

Upon request and consistent with applicable laws, Luxottica will provide reasonable accommodations to individuals with disabilities who need assistance in the application and hiring process.  To request a reasonable accommodation, please call the Luxottica Ethics Compliance Hotline at 1-888-887-3348 or e-mail HRCompliance@luxotticaretail.com (be sure to provide your name and contact information for either option so that we may follow up in a timely manner). 

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 receive preference in accordance with Tribal Law.


Nearest Major Market: Cincinnati

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