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Job Details

Claims Processor I

Honolulu, HI, United States

Posted on
Dec 01,2019

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High School Diploma or GED
Microsoft Word
10 Key Calculator
Medical Terminology
Yearly Bonus
Health Insurance
Paid Time Off
Honolulu, HI
Order Type :
Job Title:
Claims Processor I
Monday – Friday, 7:00AM – 3:30PM
Honolulu, HI
Not Provided
Pay Rate:
$14.00 – $15.25/hour
As one of Hawaii’s leading health insurance providers, we promote the overall health and well-being for all internal employees and members. Competitive long-term benefits include 100% premium paid medical insurance, 401K and PTO upon date of hire, and eligibility for annual bonuses.
OCR validation of scanned claims
Processing of CMS 1500, EDI and UB04 claims
Data entry and review of outsourced rejects
EDI or EMC claims processing
Analyzing and calculating coordination of benefit payments
Create claims processing system memo to identify, track, and pay or deny claims in accordance with the Third-Party Liability policy and medical benefits guide
Review and process CMS 1500 Out of State claims in accordance with UHA’s out of state network policy and requirement criteria
Frist Health re-pricing of applicable CMS 1500 and UB04 claims
Able to navigate through internal and external computer systems including Microsoft Word and Excel, and have proficient PC keyboarding skills including 10-key
Able to use acquired skills & knowledge and willingness to learn new skills
Must be detail oriented
Able to interpret group benefit plan coverages
Able to analyze and calculate Coordination of Benefits information
Must have thorough knowledge of the medical claims processing software applications
Able to work as a contributing team member toward achieving management’s stated goals
High School diploma
One year of work experience in an office setting, preferably associated within the healthcare industry
Understanding of medical billing, medical terminology, and/or medical coding preferred i.e. familiarity with CMS 1500, UB04, EDI CMS 1500 and EDI UB04
ID# 1303049
All offers are contingent upon the successful completion of background and reference checks. In addition, the following health screens are required:
Drug and Alcohol Testing
Interested Applicants:
Please visit us online at ****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 **MEMBERS ONLY**SIGN UP NOW***.:
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.

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