-
Operations Specialist
2 weeks ago
Piko Provisions Honolulu, United StatesAbout Piko Provisions · We founded Piko Provisions to provide the absolute best food to growing families across Hawaii. We honor the past while healing the present and foster a regenerative future - through food With your help, we will continue to be the premier resource for a gr ...
-
Operations Specialist
1 day ago
Consolidated Electrical Distributors Honolulu, United StatesJoin our CED Honolulu team as an Operations Specialist where you will play a crucial role in supporting our operations. If you enjoy giving exceptional customer service in a fast paced environment, this is the career for you As our business continue Operations Specialist, Operati ...
-
Operations Specialist
3 days ago
Consolidated Electrical Distributors Honolulu, United StatesSummary · Job title: Operations Specialist · Job ID: · Department: Honolulu - CED · Location: HI-Honolulu · Description · Summary: · Join our CED Honolulu team as an Operations Specialist where you will play a crucial role in supporting our operations. If you enjoy giving ...
-
Operations Specialist, IT
2 weeks ago
Istituto Marangoni Honolulu, United StatesAt Hawaiian Airlines, we are all about welcoming our guests with Hawaiian hospitality and aloha, and taking care of our people, our home, and the communities we serve. Join our 'ohanaand be a part of an exciting team of professionals dedicated to serving ourkama'āinaand introduci ...
-
Operations Specialist, IT
2 weeks ago
Hawaiian Airlines Honolulu, United StatesAt Hawaiian Airlines, we are all about welcoming our guests with Hawaiian hospitality and aloha, and taking care of our people, our home, and the communities we serve. Join our 'ohanaand be a part of an exciting team of professionals dedicated to serving ourkama'?inaand introduci ...
-
Planning and Operations Specialist
3 weeks ago
Booz Allen Hamilton Honolulu, United States Full timePlanning and Operations SpecialistThe Opportunity: · As an expert in defense missions, your unique background inspires you to think bigger, push further, and ask questions others don't. We need your extensive industry knowledge and advisory skills to solve some of our client's m ...
-
Future Operations Specialist
1 week ago
Booz Allen Hamilton Honolulu, United States Full timeFuture Operations Specialist The Opportunity: · As an expert in defense missions, your unique background inspires you to think bigger, push further, and ask questions others don't. We need your extensive industry knowledge and advisory skills to solve some of our client's most ...
-
Operations Specialist
1 week ago
Booz Allen Hamilton Inc. Fort Shafter, United StatesOperations Specialist · The Opportunity: · As an expert in defense missions, your unique background inspires you to think bigger, push further, and ask questions others don't. We need your extensive industry knowledge and advisory skills to solve some of our client's most complex ...
-
Booz Allen Hamilton Honolulu, United States Full timeCurrent Operations Logistics Plans and Operations SpecialistThe Opportunity: · As an expert in defense missions, your unique background inspires you to think bigger, push further, and ask questions others don't. We need your extensive industry knowledge and advisory skills to so ...
-
Booz Allen Hamilton Honolulu, United States Full timeCurrent Operations Logistics Plans and Operations Specialist The Opportunity: · As an expert in defense missions, your unique background inspires you to think bigger, push further, and ask questions others don't. We need your extensive industry knowledge and advisory skills to ...
-
Claims Operation Specialist
3 weeks ago
Hawaii Medical Service Association Honolulu, United StatesJob Summary · Pay Range: $47,500 - $88,000 · Note: Individuals typically begin between the minimum to middle of the pay range · The Claims Operation Specialist tracks, analyzes, and resolves claims and claims related system issues while collaborating with our vendor to streamli ...
-
Future Operations Specialist
1 week ago
Booz Allen Hamilton Honolulu, United StatesJob Number: R · Future Operations Specialist · The Opportunity: · As an expert in defense missions, your unique background inspires you to think bigger, push further, and askquestions others don't. We need your extensive industry knowledge and advisory skills to solve some of o ...
-
Claims Operation Specialist
2 weeks ago
HMSA Honolulu, United StatesCollect, analyze, and utilize data and feedback related to Claims to identify opportunities to improve the relationship between the business and the other entity. This will include direct communication and participation with the Vendor Management Office (VMO) and Transformation M ...
-
Claims Operation Specialist
10 hours ago
HMSA Honolulu, United StatesCollect, analyze, and utilize data and feedback related to Claims to identify opportunities to improve the relationship between the business and the other entity. This will include direct communication and participation with the Vendor Management Office (VMO) and Transformation M ...
-
Operations Specialist, IT
3 weeks ago
Hawaiian Airlines Honolulu, United StatesThe IT Field Services Team is responsible for all proprietary IT end-user hardware and provides onsite support in HNL and remote user support to all HA destinations. The Operations family houses all the specialists that monitor, change, support, and IT, Operations Specialist, Fie ...
-
Booz Allen Hamilton Honolulu, United StatesCurrent Operations Logistics Plans and Operations Specialist The Opportunity: · As an expert in defense missions, your unique background inspires you to think bigger, push further, and ask questions others don't. We need your extensive industry knowledge and advisory skills to ...
-
Court Operations Specialist V
1 week ago
Hawaii DOT Honolulu, United States Part timeRecruitment Number 24-080TY, · Court Operations Specialist V (Temporary/Part-Time), SR-24*, Honolulu, O`ahu. · Note: · The immediate vacancy is part-time, temporary, not to exceed June 30, 2025 · *Salary rate effective 07/01/2024This position is assigned to the Communications ...
-
Operations Specialist
4 weeks ago
Conservationconnections Honolulu, United StatesBecome part of Hawaii's conservation story · Reports to: · VP of Operations · Type: · Full Time, Non-Exempt · Kupu, which means "to sprout" or "to grow" in Hawaiian, has a two-fold mission: to preserve the land while empowering youth. The organization provides hands-on trainin ...
-
Court Operations Specialist III
2 weeks ago
Hawaii DOT Honolulu, United StatesRecruitment Number 23-111TY , Court Operations Specialist III (Building Management), SR-20*, Honolulu, O`ahu. · The position is full-time, temporary, not to exceed June 30, 2024 (may be extended on a year to year basis). · *Salary rate effective 7/01/2023. · This position assist ...
-
Court Operations Specialist III
1 day ago
Hawaii State Judiciary Honolulu, United StatesPosition Specific Description · Recruitment Number 23-111TY, Court Operations Specialist III (Building Management), SR-20*, Honolulu, O`ahu. · The position is full-time, temporary, not to exceed June 30, 2024 (may be extended on a year to year basis). · * Salary rate effective 7/ ...
Claims Operation Specialist - Honolulu, United States - Hawaii Medical Service Association
Description
Note:
Individuals typically begin between the minimum to middle of the pay range
The Claims Operation Specialist tracks, analyzes, and resolves claims and claims related system issues while collaborating with our vendor to streamline operational processes.
In this role, the Specialist will monitor vendor adherence to Service Level agreements, tracking issues and works with multiple areas to ensure HMSA meets all claim goals and objectives.
Exempt or Non-ExemptExempt
Minimum Qualifications
Bachelor's degree and three years of related work experience; or equivalent combination of education and work experience
Effective verbal and written communication skills.
Intermediate level knowledge of Microsoft Office applications. Including but not limited to Word, Outlook, Excel, and Power Point.
Duties and Responsibilities
Collect, analyze, and utilize data and feedback related to Claims to identify opportunities to improve the relationship between the business and the other entity.
Gathers, reviews, and analyzes information to identify trends, issues, and potential problems and solutions related to development and implementation, including but not limited to new products or services, contract deliverables, enhancements to add functionality and/or redesigns of systems, both manual and automated, to improve efficiency, financial models of costing and pricing.
This includes reviewing and validating new implementations.Initiates in the development of strategies and tactics based on logical assumptions and facts considering resources, constraints, and HMSA values.
Provides critical assessments of information and data about current trends and issues and actively and openly shares with appropriate parties to encourage collaboration for improvement and change.
Translates analysis into solutions and/or options for consideration of specific HMSA actions, including business process improvements.Initiate change and evaluate impact.
Conducts ongoing research and analysis to assess changing needs of our industry.
Provides quality, objective, and professional analysis.
Communicate with vendor and internal stakeholders to quickly and accurately obtain or provide information regarding claims processing updates:
Works directly with cross-departmental team members to complete tasks and provide status updates. Works with HMSA departments and external partners to monitor, collect, communicate, and distribute information.
Communicates analysis, assessments, recommendations and completed work product through professional written and verbal reports and presentations.
Conducts presentations to all levels of the organization (unit meetings, department meetings, management meetings, etc.) and our vendor partner to ensure reporting of quality outcomes are consistent and understood.
Communicate process changes to vendor to stay current with government and commercial health plans, agencies, and other entity's guidelines.Engages and collaborates with staff and subject matter experts with the planning and implementation of project and sub project work efforts.
Supplies or advises in the development of requirements, reports, budgets, and other analysis, and help solve operational issues and roadblocks.
Organize, maintain, and keep readily accessible, all references, documents, policies, and procedures related to claims to ensure correct application of contract benefits between HMSA and Managed Service Provider(s).
Ensures all appropriate processes are followed and documentation is completed as required by acting as quality control checkpoint verifying standards are adhered to.
Proactively solve conflicts and address issues that could occur between HMSA, customers, and service providers.Maintain knowledge of current health plan related to claims and Association requirements.
Perform all other miscellaneous responsibilities and duties as assigned or directed.
#J-18808-Ljbffr
