Claims Jobs in Honolulu hi

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Before applying for this role, please read the following information about this opportunity found below.

Join our team!

AlohaCare is a local, non-profit health plan serving the Medicaid and Medicare dual eligible population. We provide comprehensive managed care to qualifying health plan members through well-established partnerships with quality health care providers and community-governed health centers. Our mission is to serve individuals and communities in the true spirit of aloha by ensuring and advocating access to quality health care for all.

The Opportunity :

The Claims Analyst will be responsible for leading special project activities to improve the efficiency / reduce cost of processing claims. These activities could include developing new processes or recruitment activities with providers to improve the claims end-to-end experience.

Primary Duties and Responsibilities :

Analysis :

• Perform data analysis / trending to identify areas for process improvement by leveraging process automation and / or targeted provider billing guidance.
• Review pended claim reports to identify and create new workflows for process automation and analyze areas of improvements.
• Review system setup, create business configuration guidelines to reduce claims processing costs and monitor progress.
• Develop and maintain requirements / business rules for claims enhancements to comply with Federal and State requirements.

Documentation and Training :

Other Duties and Responsibilities :

Requirements :

Preferred Requirements :

Mental, Physical and Environmental Demands :

Salary Range : $24.00 - $30.00 an hour.

AlohaCare is committed to providing equal employment opportunities to all applicants in accordance with sound practices and federal and state laws. Our policy prohibits discrimination and harassment because of race, color, religion, sex (including gender identity or expression), pregnancy, age, national origin, ancestry, marital status, arrest and court record, disability, genetic information, sexual orientation, domestic or sexual violence victim status, credit history, citizenship status, military / veterans’ status, or other characteristics protected under applicable state and federal laws, regulations, and / or executive orders.

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