Case Resolution Specialist

Job Opportunity In Honolulu, HI

This job is fully in-person in Honolulu, HI. Manage appeals and grievances across all lines of business, including Medicare and Quest. Address member complaints such as rude customer service interactions and dissatisfaction with benefits. Conduct case research, draft formal letters to members, and coordinate with internal departments. Then, Medical Directors will make final decisions on cases. The role is primarily written communication; occasional phone calls may be required to explain decisions or gather additional information. Any phone calls will require the ability to handle high-stakes situations requiring calm demeanor and effective de-escalation skills.

Ideal Skills :

• Strong customer service experience
• Knowledge of healthcare benefits and industry terminology
• Excellent time management and ability to prioritize tasks
• Maintains a calm demeanor under pressure; not easily flustered

Success is measured by :

Pay and Benefits The pay range for this position is $22.00 - $23.00 / hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following :

Workplace Type This is a fully onsite position in Honolulu, HI. Application Deadline This position is anticipated to close on Oct 28, 2025.