Abacus
Description/Comment: **BACKFILL**
Claims Testing Analyst - Eyemed
BRAND: Eyemed (Background check; 5 Panel Drug Screening and OIG/GSA screenings)
Requisition Details
# of positions Needed: 1
Job Title: Analyst, Claims Testing
DATA ENTRY SCORES MUST BE LISTED AT THE TOP OF THE RESUMES. IF NOT, THEY WILL BE DECLINED.
Work hours: 7 to 3:30 or 8 to 4:30 pm
Start date: ASAP
Length of assignment: 1/31/2026
Location Address: 4000 Luxottica Place, Mason OH Remote or Onsite: Hybrid - 2x a week - Mason OH There has been a change of the hybrid requirement for this role. The new expectation will be 2 days in office 3/17 thru 5/19 with Wed being required, and then 5/19 thru end of contract it will change to 3 days in office with required days being Tues, Wed, & Thurs. 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 Required to support multiple Medicaid implementations in parallel. Responsibilities to include creating test claims, validating results and working cross-functionally to ensure testing deliverables are met.
ll 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[status][is_active]=true Sanctions List Search: OFAC: https://sanctionssearch.ofac.treas.gov/ ll EyeMed contractors must complete the following: 3 for Compliance purposes and 4 for HiTrust / Security requirements:
2024 EyeMed General Compliance 2024 EyeMed HIPAA 2024 EyeMed Fraud Waste and Abuse 2024 Conflict of Interests Acknowledgement 2024 Avoiding Dangerous Links 2024 Unintentional Insider Treats 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: dditional Job Details: DATA ENTRY SCORES MUST BE LISTED AT THE TOP OF THE RESUMES. IF NOT, THEY WILL BE DECLINED. There has been a change of the hybrid requirement for this role. The new expectation will be 2 days in office 3/17 thru 5/19 with Wed being required, and then 5/19 thru end of contract it will change to 3 days in office with required days being Tues, Wed, & Thurs. 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+ 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[status][is_active]=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. kills/Roles Certification/Credentials Clearance Other Job Position Reports To: Pager: No Laptop: No Overtime: No Weekend: No Flextime: No Travel: No Telecommute: No Clearance: No High-risk Requisition: No Background Check Required: No Drug Test Required: No ttachment:
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. nalyze 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. bility to work cross functionally. bility to multitask and manage project timelines.
PREFERRED QUALIFICATIONS
nalysis experience. Knowledge of Oracle SQL and/or Business Objects/EDW. Knowledge of Facets Knowledge of SAP Highly motivated self-starter.
Location Address: 4000 Luxottica Place, Mason OH Remote or Onsite: Hybrid - 2x a week - Mason OH There has been a change of the hybrid requirement for this role. The new expectation will be 2 days in office 3/17 thru 5/19 with Wed being required, and then 5/19 thru end of contract it will change to 3 days in office with required days being Tues, Wed, & Thurs. 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 Required to support multiple Medicaid implementations in parallel. Responsibilities to include creating test claims, validating results and working cross-functionally to ensure testing deliverables are met.
ll 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[status][is_active]=true Sanctions List Search: OFAC: https://sanctionssearch.ofac.treas.gov/ ll EyeMed contractors must complete the following: 3 for Compliance purposes and 4 for HiTrust / Security requirements:
2024 EyeMed General Compliance 2024 EyeMed HIPAA 2024 EyeMed Fraud Waste and Abuse 2024 Conflict of Interests Acknowledgement 2024 Avoiding Dangerous Links 2024 Unintentional Insider Treats 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: dditional Job Details: DATA ENTRY SCORES MUST BE LISTED AT THE TOP OF THE RESUMES. IF NOT, THEY WILL BE DECLINED. There has been a change of the hybrid requirement for this role. The new expectation will be 2 days in office 3/17 thru 5/19 with Wed being required, and then 5/19 thru end of contract it will change to 3 days in office with required days being Tues, Wed, & Thurs. 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+ 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[status][is_active]=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. kills/Roles Certification/Credentials Clearance Other Job Position Reports To: Pager: No Laptop: No Overtime: No Weekend: No Flextime: No Travel: No Telecommute: No Clearance: No High-risk Requisition: No Background Check Required: No Drug Test Required: No ttachment:
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. nalyze 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. bility to work cross functionally. bility to multitask and manage project timelines.
PREFERRED QUALIFICATIONS
nalysis experience. Knowledge of Oracle SQL and/or Business Objects/EDW. Knowledge of Facets Knowledge of SAP Highly motivated self-starter.