Claims Testing Analyst - Abacus Service Corporation
MASON, OH 45040
About the Job
| Description/Comment: | Claims Testing Analyst - Eyemed BRAND: Eyemed (Background check; 5 Panel Drug Screening and OIG/GSA screenings) Requisition Details # of positions Needed: 3 Job Title: Analyst, Claims Testing Work hours: 7 to 3:30 or 8 to 4:30 pm Start date: 09/15/2024 Length of assignment: 1/30/2025 Location Address: 4000 Luxottica Place, Mason OH Remote or Onsite: Hybrid 2x a week Mason OH o If onsite, please indicate if hybrid or workplace only Specific Skills Needed: Top 3-5 mandatory and/or minimum requirements " Experience in Claims or Data processing / testing. " Intermediate Level knowledge of PCs and spreadsheet applications. " Working knowledge of Claims Adjudication, Payments/Billing, and Data Reporting systems. " Strong communication, problem solving, teamwork and organization skills. " Strong analytical skills and critical thinking. " Ability to work cross functionally. " Ability to multitask and manage project timelines. Top 3-5 desirable attributes/qualifications? " Analysis experience. " Knowledge of Oracle SQL and/or Business Objects/EDW. " Knowledge of Facets " Knowledge of SAP " Highly motivated self-starter. Required levels/ Years of Experience education discuss whether there is flexibility Flexible **This the max amount authorized to be billed to Lux, not resources pay rate** Reason for request (Example: project base, staff augmentation, replacement or other). Can you please provide 4-5 detailed sentences as to why this temp labor is needed and why the assignment cannot be completed by an internal resource? The more details that you can provide the better your chances are of avoiding delays. I would like to start interviewing the week of 7/29/24. All 3 positions will be hybrid. All EyeMed contractors must complete 7 security and compliance training modules on Leonardo (2 hours total training) within first couple weeks of starting and annually in June. EEYEMED ONLY: As part of your contractor's compliance while working in the EyeMed department, the OIG, GSA/SAM and /OFAC screening is an additional requirement for EyeMed positions. It should be conducted prior to placement and once a month thereafter. The results should be emailed to LUXOTTICATEMPS@kellyocg.com by the 5th of each month and we again ask that you house each file internally for auditing purposes. EyeMed needs full screenshots where the website link and the date/time the screening was performed are all visible (this is required for all 3 types of screenings). Office of Inspector General: OIG: https://exclusions.oig.hhs.gov/?AspxAutoDetectCookieSupport=1 General Service Administrator List: SAM: https://sam.gov/search/?index=ex&sort=-relevance&page=1&pageSize=25&sfm%5Bstatus%5D%5Bis_active%5D=true Sanctions List Search: OFAC: https://sanctionssearch.ofac.treas.gov/ All EyeMed contractors must complete the following: 3 for Compliance purposes and 4 for HiTrust / Security requirements: q 2024 EyeMed General Compliance q 2024 EyeMed HIPAA q 2024 EyeMed Fraud Waste and Abuse q 2024 Conflict of Interests Acknowledgement q 2024 Avoiding Dangerous Links q 2024 Unintentional Insider Treats q FSL New Hire Fraud Integral Staff Training In addition; Model of Care, ODAG, and CA Fair Claims. Link: https://leonardo.essilorluxottica.com/ Model of Care, ODAG, FSL Fraud Integral Staff training, CA Fair Claims. |
Start Time: | 12:00 AM |
| Hours: | 8:00am to 5:00pm | Location: | CINCINNATI SERVICE CENTER 4000 LUXOTTICA PL MASON OH 45040 |
| Education: | |||
| Additional Job Details: | HYBRID - They will only be required to be 100% onsite during training. Which will be 1-2 weeks, depending on how quickly they catch on. Afterwards will need to be in the office 2x a week. MUST BE ABLE TO TRAIN ONSITE Specific Skills Needed: 9,000 KSH data entry speed, data entry skills, basic excel skills, attention to detail, ability to prioritize, multi-task Years of Experience: 1+ Requisition Details # of positions Needed: - 3 Job Title/Job Description Claims Testing Analyst Work hours: Start between 7-8 End between 3:30-4:30 Brand: EyeMed Start date: 9/15/2024 Length of assignment: - ends 1/30/2025 - pending extension Job Description: Validation of base data in test environment to ensure setup complete prior to commencement of testing efforts. Claims creation and validation for client testing requests and new client implementation. The Analyst will be the liaison to the Senior Analysts and Manager of the Claims Testing team to identify claims processing discrepancies due to system setup issues that require cross functional partnership and retesting. " Work with cross functional departments to ensure system is ready for testing scenarios to be keyed. " Validate the integrity of claims data in the EyeMed claims and payments UAT systems. " Track all testing defects and the status of the defect resolution through re-testing. " Analyze and document clear and concise testing results so there is a smooth transition to EyeMed claims and payments production systems. " Maintain effective, on-going communication within Claims Testing Team and other key departments. MAJOR DUTIES AND RESPONSIBILITIES " Work with cross functional departments to ensure system is ready for testing scenarios to be keyed. " Validate the integrity of claims data in the EyeMed claims and payments UAT systems. " Track all testing defects and the status of the defect resolution through re-testing. " Analyze and document clear and concise testing results so there is a smooth transition to EyeMed claims and payments production systems. " Maintain effective, on-going communication within Claims Testing Team and other key departments. Please complete the OIG/GSA/OFAC screening on your below active EyeMed Contractors and send completed screen shots within 5 business days of receipt of this email to LUXOTTICATEMPS@kellyocg.com. Once this has been completed, please send an e-mail to LuxotticaTemps@kellyocg.com and cc ydavis@luxotticaretail.com to confirm with us that this has been completed. EEYEMED ONLY: As part of your contractor's compliance while working in the EyeMed department, the OIG, GSA/SAM and /OFAC screening is an additional requirement for EyeMed positions. It should be conducted prior to placement and once a month thereafter. The results should be emailed to LUXOTTICATEMPS@kellyocg.com by the 5th of each month and we again ask that you house each file internally for auditing purposes. EyeMed needs full screenshots where the website link and the date/time the screening was performed are all visible (this is required for all 3 types of screenings). Office of Inspector General: OIG: https://exclusions.oig.hhs.gov/?AspxAutoDetectCookieSupport=1 General Service Administrator List: SAM: https://sam.gov/search/?index=ex&sort=-relevance&page=1&pageSize=25&sfm%5Bstatus%5D%5Bis_active%5D=true Sanctions List Search: OFAC: https://sanctionssearch.ofac.treas.gov/ There will actually be 5 courses that required for all temporary employees: 3 for Compliance purposes and 2 for HiTrust / Security requirements: 1. General Compliance 2. HIPAA 3. Fraud, Waste, and Abuse 4. Security Essentials 5. Introduction to Phishing In addition; Model of Care, ODAG, FSL Fraud Integral Staff training, CA Fair Claims. | ||
Attachment:
GENERAL FUNCTION
Validation of base data in test environment to ensure setup complete prior to commencement of testing efforts. Claims creation and validation for client testing requests and new client implementation. The Analyst will be the liaison to the Senior Analysts and Manager of the Claims Testing team to identify claims processing discrepancies due to system setup issues that require cross functional partnership and retesting.
MAJOR DUTIES AND RESPONSIBILITIES
- Work with cross functional departments to ensure system is ready for testing scenarios to be keyed.
- Validate the integrity of claims data in the EyeMed claims and payments UAT systems.
- Track all testing defects and the status of the defect resolution through re-testing.
- Analyze and document clear and concise testing results so there is a smooth transition to EyeMed claims and payments production systems.
- Maintain effective, on-going communication within Claims Testing Team and other key departments.
BASIC QUALIFICATIONS
- Experience in Claims or Data processing / testing.
- Intermediate Level knowledge of PCs and spreadsheet applications.
- Working knowledge of Claims Adjudication, Payments/Billing, and Data Reporting systems.
- Strong communication, problem solving, teamwork and organization skills.
- Strong analytical skills and critical thinking.
- Ability to work cross functionally.
- Ability to multitask and manage project timelines.
PREFERRED QUALIFICATIONS
- Analysis experience.
- Knowledge of Oracle SQL and/or Business Objects/EDW.
- Knowledge of Facets
- Knowledge of SAP
- Highly motivated self-starter.
Source : Abacus Service Corporation
