- Zurich NA (Honolulu, HI)
- Sr. Claims Specialist - Complex Construction Claims 117562 Zurich North America is seeking a skilled and experienced Senior Claims Specialist to join ... is essential in managing complex, high-exposure construction, and litigation claims , while supporting the New York Labor team to...while supporting the New York Labor team to ensure claims are handled efficiently and effectively, with a focus… more
- Sedgwick (Honolulu, HI)
- …Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Claims Specialist , Professional Liability **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** ... + Analyzes and processes complex or technically difficult liability claims by investigating and gathering information to determine the exposure on the claim; manages… more
- Sedgwick (Honolulu, HI)
- …Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Sr. Claims Specialist , Professional Liability (Medical Malpractice) **PRIMARY PURPOSE** : ... To analyze complex or technically difficult medical malpractice claims ; to provide resolution of highly complex nature and/or severe injury claims ; to coordinate… more
- Hawaii Pacific Health (Honolulu, HI)
- …with the managed care services department including referral management, patient steerage, and claims auditing. As the Specialist , you will be responsible for ... experience and training, as well as internal peer equity. **Position** Specialist , Managed Care - Utilization Mgmt **Category** Administrative **Employment Type**… more
- Zurich NA (Honolulu, HI)
- Senior Design/Construction Management Consulting Specialist 113183 Zurich is looking for a highly skilled **Senior Design/Construction Management Consulting ... Specialist ** within Risk Engineering and our Zurich Resilience Solutions...prospect/existing customer base. + Providing periodic support to the Claims Department with technical assessment of complex claims… more
- Walgreens (Waipahu, HI)
- …and maintaining front end and pharmacy asset protection techniques, and filing claims for warehouse and vendor overages (merchandise received, but not billed), ... for non-returnable ABC overstock. Verifies posting of all pharmacy/ prescription claims . + Completes execution of all pricing activities including price changes,… more
- Queen's Health System (Honolulu, HI)
- …efficiencies. * Ensures accurate and timely billing of patient accounts and claims submissions in accordance with policies and procedures of The Queen's Health ... third party payor requirements. * Performs duties of an Account Billing Specialist as needed. II. TYPICAL PHYSICAL DEMANDS: * Essential: sitting, seeing, hearing,… more
- Magellan Health Services (Honolulu, HI)
- …(RAPIDS) sites. + Serves as ID Card/Common Access Card (CAC) customer service specialist trained and certified by the Defense Manpower Data Center (DMDC). + Delivers ... in one of the following disciplines: Military Pay, Military Personnel, Travel Claims or Navy Transportation. Substitutions for HR background can be from similar… more
- Fujifilm (Honolulu, HI)
- …_healthcaresolutions-us.fujifilm.com_ _._ **External US** **Job Title:** **Senior Compliance Specialist ** **Job purpose** The accomplished Senior Compliance ... to healthcare Anti-bribery/Anti-corruption laws, Foreign Corrupt Practices Act (FCPA), False Claims Statute, Anti Money Laundering and other applicable US laws and… more
- Sutherland Global Services (Honolulu, HI)
- …sent to Legal. This will include: + Conducting collection activity on appealed claims by contacting government agencies, third party payers via phone, email, or ... PPO, IPA and Capitation and how these payers process claims + Knowledge of Managed Care contracts, Contract Language...billing form requirements (UB04) and HCFA 1500 + Medical claims and/or hospital collections experience + Minimum high school… more
- Queen's Health System (Honolulu, HI)
- …health plans and other third party payor requirements. * Ensures accurate claims submission to optimize revenue for the Medical Center. II. TYPICAL PHYSICAL ... desirable. B. EXPERIENCE: * One (1) year experience in medical insurance claims processing or billing. An Associate's or Bachelor's degree in business… more
- Naval Facilities Engineering Command (Honolulu, HI)
- Summary You will serve as a CONTRACT SPECIALIST in the ACQUISITION DIVISION of NAVAL FACILITIES ENG COMMAND HAWAII. Responsibilities You will negotiate changes (eg, ... modifications, supplemental agreements, justifications, approval reviews/fair opportunity evaluations and claims disputes, and contract terminations; and 4) Interpret and… more
- Defense Logistics Agency (Pearl Harbor, HI)
- …Conditions of Employment Qualifications To qualify for a Human Resources Specialist , your resume and supporting documentation must support: A. Specialized ... You MUST provide transcripts or other documentation to support your educational claims . Unless otherwise stated: Unofficial transcripts are acceptable at time of… more
- Air National Guard Units (Hickam AFB, HI)
- …SERVICE POSITION. This National Guard position is for a SAFETY AND OCCUPATIONAL HEALTH SPECIALIST , Position Description Number D2205P01 and is part of the HI 154 WG, ... You must provide transcripts or other documentation to support your Educational claims . To receive credit for Education, you must provide documentation of proof… more
- TEKsystems (Honolulu, HI)
- …specialists work with insurance providers to resolve issues related to claims . This includes investigating and analyzing data, maintaining and updating contracts, ... They enter provider information into the database and work to ensure that claims payments are accurate. They must adhere to all requirements, rules, and regulations.… more
- Highmark Health (Honolulu, HI)
- …with a basic understanding of various payer billing requirements and claims processing or experience with payer credentialing/enrollment requirements + Advanced ... computer skills using word, excel, adobe and web-based applications + Excellent customer service, follow-up, and communication skills Preferred + Associate's degree + Certified Provider Credentialing Support (CPCS) by the National Association Medical Staff… more
- Product Connections (Honolulu, HI)
- …to perform the essential duties. _Responsibilities With Regard to Workers' Compensation Claims :_ You are responsible for reporting all employment related injury you ... incur to your direct supervisor as soon as possible following an incident resulting in an injury. **Qualifications** _Education/Experience:_ High school diploma or general education degree (GED); or one to three months' related experience and/or training; or… more
- Queen's Health System (Honolulu, HI)
- …plans and other third party payor requirements, as assigned. * Ensures accurate claims submission to optimize revenue for the Medical Center, as assigned. * Responds ... to patient and insurance inquiries promptly and courteously. II. TYPICAL PHYSICAL DEMANDS: * Essential: standing, sitting, walking, seeing, hearing, speaking, finger dexterity, repetitive arm/hand motions and gripping of an object. * Operates various office… more
- Reyes Holdings (Waipahu, HI)
- …initiating and implementing safety and prevention programs and coordinating claims management activities and developing, managing and evaluating wellness programs ... (TPA), and to mitigate future similar injuries. + Work with the TPA claims adjusters to ensure proper and efficient handling of Workers' Compensation, Auto… more
- HealthEdge Software Inc (Honolulu, HI)
- **Overview** **Position Overview:** We are seeking a Senior Payment Integrity Specialist to play a key role in building and implementing proprietary healthcare edits ... that drive cost savings and accuracy in claims processing. The successful candidate will be responsible for...responsible for taking a senior level role in analyzing claims data, as well as translating contract terms, policies,… more