CashClaims Processor Assignment

Job Title : Cash / Claims Coordinator

Location : 4000 Luxottica Place Mason OH 45040 (Hybrid 3 days per week onsite mandatory)

Duration : 3 Months possible extensions / Temp-to-Hire

Pay Rate : $17.00 21.00 / hr. W2 All Inclusive

Work Schedule : Monday Friday 9 : 00 AM 5 : 00 PM (Flexible 40 hours per week)

Start Date : Immediately

Interview Mode : Onsite

GENERAL SUMMARY

The Cash / Claims Coordinator is responsible for billing medical claims applying cash and working the aged trial balance by identifying fixing and resubmitting claims to insurance carriers. Candidates must have recent and relevant experience in vision claims coding billing and cash application processes.

MAJOR DUTIES AND RESPONSIBILITIES

• Manage the flow of processes completed by Cash Processors to ensure all cash is applied in a timely manner to outstanding invoices and provide daily updates to the Cash Supervisor .
• Document and track statistics of all cash-related processes and report results to the Cash Supervisor .
• Train associates on how to process transactions including researching and applying cash for both Payers and Members identifying and documenting partial payments and denials and scanning completed batches into Filebound.
• Complete and submit EFT setup applications and documentation reporting any issues promptly.
• Act as a point of contact for any cash-related questions or issues from other internal departments.
• Serve as Filebound system point of contact for related inquiries.
• Attend meetings and conference calls as requested by the Cash Supervisor to provide insight on cash processes for internal or external customers.
• Schedule and coordinate monthly team meetings .
• Support and maintain relationships with designated Payers including providing frequent updates to management.
• Work pre-bill queries weekly to ensure accurate claim submissions and minimize denials .
• Analyze open receivable trends including payment frequency and root cause analysis .
• Research and resolve insurance denials for proper resubmission of claims within required time frames.
• Resolve or escalate provider plan setup store or system issues accurately and in a timely manner.
• Run and work various AS400 queries weekly and perform data analysis in Microsoft Excel .
• Summarize outstanding accounts receivable (AR) issues and provide recommendations and solutions .
• Analyze collections data quarterly and develop projects based on P&L risk by payer including forecasting expected payments and providing visibility to resolution.
• Support Canadian receivables collections including write-offs (adjustments) monthly ATB analysis and issue resolution .
• Assist the Supervisor with special projects and training as needed.

KNOWLEDGE AND SKILLS

EDUCATION AND EXPERIENCE REQUIREMENTS

CANDIDATE SELF-ASSESSMENT QUALIFYING SKILL MATRIX

Please fill out the below matrix while applying. Use a scale of 1 (Beginner) to 10 (Expert) for the Self-Rating column.

Skill Category

Required / Preferred

Skill Description

Self-Rating (1 10)

Years of Experience

Additional Notes / Comments

Vision Claims Billing

Required

Hands-on experience in vision claims coding billing and submission

Cash Application

Required

Applying cash managing payments and reconciling outstanding balances

Denial Management

Required

Researching and resolving insurance denials and resubmitting claims accurately

Accounts Receivable (AR) Analysis

Required

Analyzing open receivables trends and payment frequency

Claims Processing Systems (AS400 Filebound)

Required

Experience with AS400 queries and Filebound system for cash processing

Microsoft Excel

Required

Data analysis reporting and tracking using Excel functions

Training & Mentoring

Preferred

Training team members on cash processes and documentation

Communication Skills

Preferred

Effective oral and written communication with teams and management

Problem Solving / Analytical Skills

Required

Ability to identify root causes provide solutions and analyze data

Customer Service

Preferred

Providing support to payers and internal teams with accuracy and professionalism

Continuous Improvement

Preferred

Applying process improvement or lean thinking in cash operations

Confidentiality & Integrity

Required

Maintaining data privacy and ethical standards

Key Skills

Loan Processing,Typing,Data Entry,Customer Service,Organizational skills,Basic Math,Computer Skills,Fraud,Microsoft Outlook,10 Key Calculator,Fair Housing Regulations,Food Processing

Employment Type : Full Time

Experience : years

Vacancy : 1