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Job Details

Internal Auditor

Location
Mason, OH, United States

Posted on
Jul 12,2019

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Education
Bachelor's Degree
Skills
Customer Service
Analysis Skills
Benefits
Vision Insurance
Requisition ID:
105445
Position:
Full-Time
There’s more to EyeMed than meets the eye. EyeMed is the fastest growing managed vision benefits company in the country with consistent double-digit membership growth! Through our commitment to innovation, we’re reimagining the way employers and their employees think about vision care. We want them to see life to the fullest and experience more of what’s best, not more of the same. And if what’s best hasn’t been done yet, it’s our exceptional and passionate employees driving this change. But, our passion for vision isn’t just about vision insurance benefits. Our employees are proud to support and participate in life-altering global and local missions through our partnership with OneSight, a leading not-for-profit organization with a 100% focus on eradicating the world’s vision crisis.
Your family says a lot about who you are. EyeMed is a key member of the Luxottica family of companies, global leaders in the design, manufacture and distribution of fashion, luxury and sports eyewear. In North America, Luxottica is the home to global brands Ray-Ban, Oakley and many top fashion house brands. Our leading retail brands include LensCrafters, Sunglass Hut, Pearle Vision, Target Optical and Sears Optical.
If you’re passionate about driving innovation and change and interested in a career in the optical and insurance industry, EyeMed wants to start the conversation and help provide you a growth-focused opportunity with America’s fastest growing vision benefits company.
GENERAL FUNCTION
This role will support the claims pre-payment and post-payment audits for the In-Network, Out-of-Network, and Adjustments processing teams. This role will be responsible for reporting completed audit results to internal customers.
MAJOR DUTIES AND RESPONSIBILITIES
Performs pre-payment audits daily and communicates results daily.
Performs post-payment audits daily and records results daily for end of the month reporting.
Works with manager to identify error trends and resolutions.
Supports all constituents with pre-audit work including answering questions and following up on requests and findings timely.
Supports the maintenance for internal audit procedures that ensure claims are processed in compliance with EyeMed standards and state regulations.
Review provider receivables due to dispensing model.
Assists with corporate initiatives that involve claims processing documentation and process review. Provide support for all related audit initiatives, including new and renewing plan designs, claim questions and payment/billing related issues.
Provide recommendation for reoccurring errors or trends.
Research specific claim issues
Assist with special projects.
BASIC QUALIFICATIONS
Bachelor’s Degree
At least 3 years Information Systems related experience
PREFERRED QUALIFICATIONS
1-3 years internal/external auditing experience including development of internal control functions.
Experience in the insurance industry.
Understands third party benefits and administration.
Strong background driving internal and external auditing and process documentation skills while challenging existing processes and driving process improvement.
Attention to detail and urgency to complete tasks and responsibilities.
Experience with PCs and query reporting.
Strong analytical skills.
Strong customer service focus.
Ability to identify problems as well as the initiative to recommend solutions to supervisor.
Ability to work well under pressure.
Upon request and consistent with applicable laws, Luxottica will provide reasonable accommodations to individuals with disabilities who need assistance in the application and hiring process. To request a reasonable accommodation, please **** outside of US) or email ****
We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, gender, national origin, religion, age, disability, sexual orientation, gender identity or expression, citizenship, 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.
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