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Kapolei

    Operations Coordinator I - Kapolei, United States - HMSA

    HMSA
    HMSA Kapolei, United States

    1 week ago

    Default job background
    Description
    Coordinate and monitor daily workload of MM operations staff to ensure all applicable performance standards/expectations are met. Act as primary point of contact and back up for certain tasks as assigned.

    Evaluate and document the accuracy of various work processes through monitoring/audits. Identify training needs and report to management.

    Develop, document, and communicate workable, positive solutions, processes, and/or workflows taking into account regulatory, accreditation, service level agreements and the "whole" company perspective.

    Handle non-routine inquiries/requests and write/audit provider and member letters.

    Coordinate and/or conduct department and inter-departmental activities related to
    claim recoupment and replacement for cost savings/cost avoidance. Ensure that MM
    systems are updated accurately and timely and review relevant reports.

    Provide accurate and timely information to MM operations staff on new and updated processes/procedures/workflows. Document and disseminate materials to staff.

    Other duties as assigned.

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