Claims Processor I

4 weeks ago

Honolulu, United States Pacific Administrators, Inc. Full time
Job DescriptionJob Description

Description

Responsible for the processing of all medical, hospital, vision, chiropractor, and ancillary claims, which includes
coordination of benefit and third-party liability claims in accordance with department policies and procedures.

Skills / Knowledge Requirements

  • Type 45 WPM
  • 10 Key by Touch
  • Computer literate in Word and Excel and other Microsoft applications
  • Good organization skills and ability to handle multi tasks
  • Good analytical skills
  • Self-starter and quick learner
  • Knowledge of ICD-9, ICD-10, CPT, HCPCS, FORM 1500, and UB04 forms, Medical and Revenue Coding, and Medical Terminology a plus
  • Minimum of (2) year of work experience or equivalent (combination of education and work)
  • Process Medical claims
  • Process Hospital and Ancillary Claims
  • Process Vision and Chiropractic Claims
  • Send referrals to Managed Care Department
  • Send claims to contract negotiator for individual negotiations
  • Correct and submit error tickets
  • Process Claim Adjustments
  • Assist Customer Service Department with customer inquiries
  • Assist Department Lead and/or Supervisor with other departmental or Health and Welfare duties
  • Be able to maintain error rate and production quotas

Other Duties

  • As needed by the department supervisor

Physical Demands

  • Lifting and carrying file boxes within the office

Working Conditions

  • Indoors, air-conditioned office

Work Shift

  • Monday to Friday, 8:00 AM – 4:30 PM 1-hour unpaid lunch
  • The duties assigned may involve situations that will require overtime.
Company DescriptionOur Company and Mission

Pacific Administrators, Inc. is a technology-driven third-party administrator in Hawaii that provides employee health and welfare, pension, annuity, and vacation benefit services for many local union members. We take pride in the fact that our company is locally owned and operated. Our company motto is 'Kulia I Ka Nu'u', which means 'Strive for the Highest' - best service, positive attitude, teamwork, training, attaining goals (personal, department, company), solving problems/learn/move forward. Our corporate mission is to be the industry leader in quality service to our valued customers.

Our Corporate Culture

We are a humble team of equals who have positive attitudes, treat everyone with respect and fairness, work together, have a strong ‘work ethic’, and who are dedicated to providing exceptional customer service.

Our Core Values

• Walk the Talk - Lead by example, listen, coach, train; always with respect.
• Attitude of Gratitude - Value our employees, clients and service providers.
• Do What it Takes - We are all accountable, relied upon and appreciated.
• Kulia I Ka Nu'u - Service excellence to our customers, our participants, our service providers and one another.
• Same Canoe - Our Helmsman steers our canoe and guides us forward. As a team, we are all: "paddling together" in sync, positive, considerate and communicative with one another.Company DescriptionOur Company and Mission\r
\r
Pacific Administrators, Inc. is a technology-driven third-party administrator in Hawaii that provides employee health and welfare, pension, annuity, and vacation benefit services for many local union members. We take pride in the fact that our company is locally owned and operated. Our company motto is 'Kulia I Ka Nu'u', which means 'Strive for the Highest' - best service, positive attitude, teamwork, training, attaining goals (personal, department, company), solving problems/learn/move forward. Our corporate mission is to be the industry leader in quality service to our valued customers.\r
\r
Our Corporate Culture\r
\r
We are a humble team of equals who have positive attitudes, treat everyone with respect and fairness, work together, have a strong ‘work ethic’, and who are dedicated to providing exceptional customer service.\r
\r
Our Core Values\r
\r
• Walk the Talk - Lead by example, listen, coach, train; always with respect. \r
• Attitude of Gratitude - Value our employees, clients and service providers.\r
• Do What it Takes - We are all accountable, relied upon and appreciated.\r
• Kulia I Ka Nu'u - Service excellence to our customers, our participants, our service providers and one another.\r
• Same Canoe - Our Helmsman steers our canoe and guides us forward. As a team, we are all: "paddling together" in sync, positive, considerate and communicative with one another.

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