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Claims Processor

Claims Processor
OH - Mason

Job Description

Hours: M-F/Full-Time; 8-4:30 (30-Minute lunch)

WFH: Yes, we will likely be WFH 100% through the remainder of the year, but candidate must be flexible to come into the CSC if directive is otherwise given.

Must have adequate WFH space and follow all remote protocol.



Characteristics of an ideal candidate:

Ability to learn and adopt new processes quickly and with ease

Ability to work remotely and autonomously

Accustomed to working in a high-paced, high-volume environment

Strong attention to detail

Medium-Advance level of expertise with Microsoft Excel

Proficient with Outlook

Familiar with Cloud-based applications (i.e. OneDrive)

Ability to multi-task and perform duties using multiple sources or systems; Data Entry experience preferred

Ability to clearly articulate findings, issues or concerns requiring resolution



Value Prop for Consultant:

Provides the employee with exposure to a fast-paced, high-volume environment where they are adding value to a department that has maintained 100% client satisfaction 12 years in a row for the nation's fastest growing vision care company.

Provides a "foot in the door ata company that has multiple facets and opportunities for candidates that want to work hard to succeed in multiple roles.



Job Description:

The ideal candidate will be responsible for the timely and accurate completion of key tasks supporting the successful implementation of new Small Business Clients with and/or on behalf of a team of Implementation Specialists.



Responsibilities during this assignment can include:

Execute the preliminary steps to build a new client structure for implementation requests routed through shared Salesforce queue; using standard client set-up guideline(s) and process(es)

Initiation of and accurate and timely tracking for all completed tasks using proprietary Salesforce Implementation Tracker Project Management tool

Benefit set-up validation in core Facets system and communicating to implementation owners any discrepancies with expected outcome

Execution of new client online portal access set-up; includes sending the appropriate communication email templates, tracking status and reporting any identified issues.

Monitor team shared Outlook mailbox for incoming membership documents sent from clients, brokers or Third Party Administrators (TPA's)

Review incoming membership documents (Microsoft Excel and Word) to confirm accuracy in formatting and validity of data; includes communicating when updates are needed for successful membership enrollment and/or submission for processing.





Nesco Resource and affiliates (Lehigh G.I.T Inc, and Callos Resource, LLC) is an equal employment opportunity employer and does not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, or veteran status, or any other legally protected characteristics with respect to employment opportunities.

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