Honolulu, Hawaii
Claims Processor I (290434) Job Opening in Honolulu, Hawaii - Job Title: Claims Processor I
Industry: Healthcare
Duration: Temp-to-Hire
Hours: Monday ? Friday, 8:00AM ? 4:30PM
Location: Honolulu, HI
Parking: Not Provided
Description:
Responsible for Optical Character Recognition (OCR) validation of scanned claims
Process for payment all assigned EDI (electronic data interchange) and/or outsourced claims, which includes but is not limited to medical and vision claims submitted by rendering providers, facility inpatient, and outpatient hospital to meet the department?s established performance standards, State of Hawaii Revised Statutes? claims turnaround and department?s payment accuracy
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 out of state network policy and requirement criteria
First Health re-pricing of applicable CMS 1500 and UB04 claims
Requirements:
Able to navigate through internal and external computer systems including Microsoft Word and Excel, and have proficient PC keyboarding skills
Able to use acquired skills & knowledge and willingness to learn new skills
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 or 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, EDI UB04 and DMR
Able to use ten key and typewriter by touch with a minimum of 10,000 keystrokes per hour
CPC (Certified Professional Coder) preferred
Pay Rate: $12.75 /hour
ID# 290434
All offers are contingent upon successful completion of background and reference checks. In addition, the following health screens are required:
Drug & 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.
Staffing Solutions of Hawaii:
Staffing Solutions of Hawaii is a local, award winning, and growing privately owned agency in Oahu. For more than 20 years, our personal approach to building our relationships with renowned companies ensures our employees enjoy competitive pay, stimulating careers and assignments, and excellent growth opportunities, with the chance for it to turn into full-time employment!
We are proud to be an Equal Employment Opportunity and Affirmative Action employer, including females, minorities, protected Veterans and those with disability.
Job Type: Full-time
Salary: $12.75 /hour
Job Location:
Honolulu, HI
Required education:
High school or equivalent
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