Claims Coordinator (TeamVision)

Requisition ID:914974
Store #:X00526 Team Vision RCM FIELD
Position:Full-Time
Total Rewards:Benefits/Incentive Information

If you've worn a pair of glasses, we've already met.

We are a global leader in the design, manufacture, and distribution of ophthalmic lenses, frames, and sunglasses. We offer our industry stakeholders in over 150 countries access to a global platform of high-quality vision care products such as the Essilor brand, with Varilux, Crizal, Eyezen, Stellest and Transitions, iconic brands that consumers love such as Ray-Ban, Oakley, Persol and Oliver Peoples, as well as a network that offers consumers high-quality vision care and best-in-class shopping experiences such as Sunglass Hut, LensCrafters, and Target Optical, and leading e-commerce platforms.

Our portfolio of more than 150 renowned brands span various categories, from frames, lenses and instruments to brick and mortar and digital distribution as well as mid-range to premium segments. Our Shared Services Team, accompany and enable others within the EssilorLuxottica collective to achieve their targets. They keep people and projects running smoothly, ensuring every part of our business is provided for and well taken care of.

Join our global community of over 200,000 dedicated employees around the world in driving the transformation of the eyewear and eyecare industry. Discover more by following us on LinkedIn!

GENERAL FUNCTION

The Medical Claims Coordinator is responsible for monitoring insurance carrier adjudication of TeamVision medical claims for one or more doctor practices. Utilize a practice EHR system and clearing house to review and submit claims to multiple insurance carriers Review open/unpaid claim balances and take required action.

MAJOR DUTIES & RESPONSIBILITIES

• Review medical claims and transmit to the insurance carrier using the practice electronic health records (EHR) system and clearing house.
• Monitor rejected claim reports and adjust claims for resubmission to the insurance carrier.
• Download insurance carrier evidence of benefits (EOBs) to post claim payments and denials in the EHR system.
• Determine if denied claims can be adjusted and re-submitted to the carrier.
• Review aging reports to research open balances and resubmit within insurance carrier filing limits.
• Utilize insurance carrier websites and contact carriers as needed to investigate denials and claim status.
• Partner with the clearing house to distribute patient billing statements and monitor the patient portal to post payments in the EHR system.
• Initiate overpayment refunds to patients and repayments to insurance carriers when required.
• Write-off open claim balances in the EHR system.
• Serve as the point of contact for the practice regarding all vision and medical claims.
• Support the corporate manager in maximizing claim collection rate.

BASIC QUALIFICATIONS

• High school diploma
• 3+ years of related work experience
• Experience with medical vision claims and coding
• Ability to prioritize handling of issues
• Organization skills and ability to multitask
• Effective communication skills (verbal, written, listening, presentation)

PREFERRED QUALIFICATIONS

• Experience working in multiple doctor practices
• Experience working with multiple insurance carriers and an understanding of their claim requirements
• Proven ability to identify issues and solve problems

This posting is for an existing vacancy within our business.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. If you would like to provide feedback regarding an active job posting, or if you are an individual with a disability who would like to request a reasonable accommodation, please call the EssilorLuxottica SpeakUp Hotline at 844-303-0229 (be sure to provide your name, job id number, and contact information so that we may follow up in a timely manner) or emailHRCompliance@luxotticaretail.com.

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.