- Sedgwick (Honolulu, HI)
- …Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Sr. Claims Specialist Professional Liability, Public Entity **PRIMARY PURPOSE** **:** ... entity; to provide resolution of highly complex nature and/or severe injury claims ; to coordinate case management within Company standards, industry best practices… more
- Lincoln Financial Group (Honolulu, HI)
- …73468 **The Role at a Glance** We are excited to bring on highly motivated Voluntary Claims Specialist I to staff our ever-growing claims organization. As a ... administering, processing, and adjudicating Accident, Critical Illness, and Hospital Indemnity claims for our members. You'll complete a thorough training to develop… more
- Lincoln Financial Group (Honolulu, HI)
- …**The Role at a Glance** We are excited to bring on a highly motivated **Group Claims Specialist ** to support our ever-growing claims organization in a work ... support our west coast employer groups. _Background details_ As a Group Claims Specialist , you will support our Short Term Disability or Integrated Absence… more
- Humana (Honolulu, HI)
- …a part of our caring community and help us put health first** The Claims Financial Recovery Coding Specialist /Medical Coding Coordinator 2 for the Financial ... claims procedures, contract provisions, and CMS guidelines. The Claims Financial Recovery Coding Specialist / Medical...CMS guidelines. The Claims Financial Recovery Coding Specialist / Medical Coding Coordinator 2 + Maintains required… more
- Trustmark (Honolulu, HI)
- …colleagues, clients and communities. Responsible for reviewing and processing claims including, identifying irregularities and reviewing for accuracy, and ... Critical Care. **Key Accounabilities:** + Demonstrates strong understanding and performs claims handling processes and procedures related to Wellness, Hospital and… 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
- Sedgwick (Honolulu, HI)
- …to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Return-to-Work Specialist **PRIMARY PURPOSE** : To negotiate, facilitate and monitor successful ... Determines objective, quantifiable, medically supported work restrictions for assigned claims . + Facilitates return-to-work (RTW) efforts through negotiation with… 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 (Honolulu, 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
- Robert Half Office Team (Honolulu, HI)
- Description Robert Half is looking for an experienced HR/Benefits Specialist for an awesome opportunity for a national company. Job Summary: We are in search for a ... skilled and motivated HR/Benefits Specialist to enhance the Human Resource Department's capability to...employees with health, dental, life, and other related benefit claims . * Make sure the company's benefits policy complies… 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
- Travelers Insurance Company (Honolulu, HI)
- …of the scene and to provide technical advice and consultation to attorneys and claims staff associated with the loss. + Conduct research and testing, prepare reports ... (verbal and written), and to aid the claims and legal staff with the scientific aspects of...needed to support the overall functions of Risk Control, Claims Services, and Underwriting. Such materials may include newsletters,… 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)
- …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
- CROSSMARK (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
- Hawaiian Electric (Honolulu, HI)
- …stored information for internal or external investigations, incident response, claims , litigation and regulatory proceedings for the company ESSENTIAL FUNCTIONS: ... of systems and devices for internal or external investigations, incident response, claims , litigation, and regulatory proceedings. + Engages closely with the General… more
- Guardian Life (Honolulu, HI)
- …The Vocational Rehabilitation Consultant provides assessment of LTD, STD and Life claims , to determine claimants' level of functionality and provide evaluation of ... of RTW. Serve as educational resource on vocational rehab aspect of claims . Educate parties involved in claim management regarding the extent of functional… 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
- Highmark Health (Honolulu, HI)
- …quotes and analyzes the structure of a contract for a group based on claims experience, characteristics of the employee groups, etc. The incumbent uses discretion of ... questionable claim patterns of renewal clients and issues with competitor's claims experience for prospect clients and develops recommendations to account for… more
- Wolters Kluwer (Honolulu, HI)
- …increase operational efficiency and reduce costs. Corporate legal and insurance claims departments trust our innovative technology and end-to-end customer experience ... and achieving new business growth. As an Enterprise Software Sales Industry Leader Specialist this role will play a pivotal role in driving new business development… more