WHO WE ARE
We are EssilorLuxottica, a global leader in the design, manufacture and distribution of ophthalmic lenses, frames and sunglasses.
The Company brings together the complementary expertise of two industry pioneers, one in advanced lens technologies and the other in the craftsmanship of iconic eyewear, to create a vertically integrated business that is uniquely positioned to address the world’s evolving vision needs and the global demand of a growing eyewear industry.
With over 180,000 dedicated employees in 150 countries driving our iconic brands, our people are creative, entrepreneurial and celebrated for their unique perspectives and individuality.
Committed to vision, we enable people to “see more and be more” thanks to our innovative designs and lens technologies, exceptional quality and cutting-edge processing methods.
Every day we impact the lives of millions by changing the way people see the world.
GENERAL FUNCTION
The Medical Claims Specialist, reporting to the Revenue Cycle Supervisor, is responsible for processing accurate accounts receivable information and collecting outstanding balances.
This individual will maintain accounts receivable activities, including but not limited to review medical billing codes, reconcile account balances between two systems, resolve payment issues and other various accounts receivable administrative duties.
MAJOR DUTIES AND RESPONSIBILITIES
AR maintenance, including resolving payment discrepancies, tracking invoice payments, reconciling balances and analyzing variances between systems.
Identifying claim payment denials, submitting corrected claims for payment and notifying appropriate parties of account issues
Reviewing medical billing codes for accuracy and resolving all claim discrepancies
Sending billings and receiving remittances via EDI 837 and 835 files
Knowledge of clearinghouse and State Medicaid portals for daily use of claim submission, payment remittance retrieval, and tracking billing file acceptances
Identifying and reconciling overpayments in a timely manner
Assisting with Key Performance Indicator (KPI) tracking and engages others to improve metrics.
Reduces ratio of denied claims versus credited claims to collect more on assigned accounts
BASIC QUALIFICATIONS
High School education or equivalent
2-4 years Accounts Receivable related experience and/or training
Basic understanding of U.
S.
Generally Accepted Accounting Principles (GAAP), understanding of the importance of timely revenue recognition, payment posting, and credit timing
Microsoft Suite proficiency
Ability to work both independently and collaboratively
Solution-oriented
PREFERRED QUALIFICATIONS
Medical billing and coding certification
Electronic Data Interchange (EDI) 837 and 835 experience
Knowledge of clearinghouse and state Medicaid portals
familiarity with CPT and ICD-10 codes
Intermediate Microsoft Excel skills, including the ability to manipulate large sets of data and the use of VLOOKUP formulas and pivot tables.
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/Incentive Information including health benefits, PTO, 401K, paid family leave, tuition reimbursement, and eyewear discounts.
Upon request and consistent with applicable laws, EssilorLuxottica 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 (be sure to provide your name and contact information so that we may follow up in a timely manner) or email HRCompliance@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 receive preference in accordance with Tribal Law.
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