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EyeMed - Team Lead - Claims

Date: 
Brand:  EyeMed Vision Care
Location: 

Mason, OH, US, 45040

Requisition ID: 157193 
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

This position is responsible for providing guidance and subject matter expertise to support timely and accurate managed vision claims processing. The claims team leader reports directly to the claims production team manager and assists with executing the team and department goals to exceed key performance measures, including leading the administration and resolution of transactional quality, staff training and all other claims processes in a timely and satisfactory manner that satisfies the plans, members, and EyeMed.

 

MAJOR DUTIES AND RESPONSIBILITIES

  • Independently manage daily work activities to support the successful processing of managed vision care claims
  • Provide subject matter expertise regarding all aspects of the claims processing functions directly supporting the claims processors and other department team members
  • Assists in monitoring daily claims production outcomes and proactively resolving production impacting issues
  • Identify and work with management to resolve complex problems and when appropriate, initiate changes to prevent future problems
  • Assists in evaluating and recommending changes to department standard operating procedures to drive improvements to claims processor accuracy and efficiency
  • Assists the claims production manager with new employee onboarding activities, including training, job shadowing and providing inputs into individual performance metrics
  • Ability to establish and maintain effective working relationships and communicate clearly with all department team members
  • Assist with providing oversight of external vendors supplying staffing and technology solutions, to ensure alignment to contractual obligations
  • Maintain strict adherence to all HIPAA and corporate data security guidelines/regulations

 

BASIC QUALIFICATIONS

  • College degree or equivalent work experience
  • At least 3 years of Claims processing or data entry experience
  • Working knowledge of MS Office suite (word processing, spreadsheets, etc.)
  • Good written and verbal communication skills

 

PREFERRED QUALIFICATIONS

  • Prior experience in a Team Leader role
  • Knowledge of CMS Medicare and Medicaid regulations
  • Experience with the Facets Core platform, specifically Medical Claims Processing

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

Job Segment: Medical, Manager, Medicaid, Medicare, Data Entry, Healthcare, Management, Administrative