Claims Coordinator

Job Title: Claims Coordinator

Industry: Healthcare

Duration: Temporary, ASAP – 6 months w/ possible extension

Hours: Full-time, 39-hour work week

• Monday to Thursday (8-hour workday): Start time of 7:00 or 7:30 am and a 30-minute or 1-hour lunch break (e.g., 7:00 am to 3:30 pm with a 30-minute lunch break)

• Friday (7-hour workday): Same start time as Monday to Thursday and end time would be one-hour early (e.g., 7:00 am to 2:30 pm with a 30-minute lunch break)

• Must be in-office daily (remote work is not an option)

Location: Honolulu, HI

Parking: Not Provided *Paid parking available at discounted rate*

Pay Rate: $15.00/hour

This organization is local health insurer that has been serving the health and wellness needs for Hawaii for over 30 years. They are one of the largest health insurers in the state and continue to provide exceptional benefits, one-on-one personalized services, flexibility and choices for Hawaii’s businesses. They also offer great benefits, growth and advancement within their company!

Position Summary:

Batches incoming claims for the vendor to scan. Enters claims data that miss the EDI claim loads. Ensures claims are routed in a timely manner. Maintains an Excel spreadsheet of claims pended by various departments.

Description:

• Sorts, counts and prepares incoming paper claims for scanning.

• Sorts and batches claims correspondence for scanning.

• Generates and prints daily letters from the claims system.

• Returns claims to providers and/or to members due to missing information.

• Hitches scanned and pre-logged claims, correspondence and attachments via the SmartDataSolutions (SDS) portal to the claim in the claims system.

• Prepares claims for review by external vendors.

• Works on SDS eligibility matching under the member matching queue as needed.

• Routes and tracks claims pended to other departments.

• Enters claims in the claims system as needed.

• Prepares the Adjustor Daily Summary report daily as needed.

• Generates system letters for pended claims; then routes pended claims and/or the Excel spreadsheet to appropriate departments.

• Follows up with other departments on pended claims.

• Handles or distributes internal and external department mail.

• Must comply with Company and Departmental policies and procedures.

• Performs other duties as assigned.

• Must be present in the office to perform the job functions, except for external meetings and events.

• Job may be modified at any time.

Requirements:

• High school diploma or GED is required.

• One year of experience in claims administration or a related area is preferred.

• Strong analytical, organizational, time management, and verbal and written communication skills; and careful attention to detail required.

• Ability to prioritize, consistently meet timelines, and multi-task required.

• Ability to work independently and in a team environment required.

• Basic-level proficiency in Microsoft Word and Excel skills required.

• Ability to add, subtract, multiply, divide, and calculate figures and amounts required.

• Basic-level proficiency in Microsoft Outlook preferred.

• Able to remain in a stationary position and work on a computer for up to eight hours per workday.

• Frequently moving paper and hard copy files.

• Able to use standard office equipment such as computers, phones, photocopiers, and filing cabinets.

ID# 1644184

All offers are contingent upon the successful completion of background and reference checks. In addition, the following health screens are required:

• Must show proof of being fully vaccinated against COVID-19 unless a reasonable accommodation is approved. If partially vaccinated, or approved for a vaccine exemption, employees must comply by submitting weekly negative test results from an approved COVID-19 test (PCR or NAAT).

Interested Applicants: Please visit us online at www.staffingsolutionsofhawaii.com to view additional positions. Applications will only be reviewed for applicants currently living in the state of Hawaii and who are available for an interview with Staffing Solutions. #SSOH

Why work with Staffing Solutions of Hawaii:

• We are a local, award winning, and growing privately owned agency in business for 25 years

• Employees enjoy competitive pay, stimulating careers, and excellent growth opportunities!

• We have over 120 job positions including full-time, part-time, and internship opportunities inclusive with medical benefits options

• We partner with 100+ organizations in Hawaii, such as Kaiser Permanente, Bank of Hawaii, Hawaiian Airlines, Hilton Grand Vacations, KHON 2 News and many more!

We are proud to be an Equal Employment Opportunity and Affirmative Action employer, including females, minorities, protected Veterans and those with disability.