Claims Processor I

Pacific Administrators; Honolulu (HI); On-site; USD 42,000 - 56,000; Full time

Benefits offered by this job

Medical, Dental, Vision Insurance

401(k) Plan with Company Match

Paid Vacation, Sick and Personal Time

Commuter Benefit

Job summary

Pacific Administrators in Honolulu, HI seeks a Claims Processor I to work under the Claims Department Supervisor. Responsibilities include processing medical, hospital, vision, chiropractic and ancillary claims, ensuring accurate coordination of benefits and third-party liability claims, and assisting the department with inquiries and duties.

The role requires at least 2 years of experience or equivalent, strong typing (45 WPM) and 10-key by touch, and proficiency in Word/Excel.

Qualifications

• Minimum of 2 years work experience or equivalent (education/work).
• Typing 45 WPM.
• 10-key by touch.
• Microsoft Word and Excel proficiency.
• Good organization skills and the ability to multitask.
• Strong analytical skills.
• Self-starter and quick learner.

Responsibilities

• Process medical, hospital, vision, chiropractic and ancillary claims.
• Coordinate benefit and third-party liability claims per policies.
• Send referrals to Managed Care Department and to contract negotiator.
• Submit and correct error tickets; process claim adjustments.
• Assist Customer Service with inquiries and support other duties.
• Maintain error rate and production quotas.
• Occasional lifting and transporting of supplies.

Skills

Typing 45 WPM

10-key by touch

Analytical skills

Organization

Self-motivated

Tools

Word

Excel

Job description

About Pacific Administrators

Pacific Administrators (PAI) was founded in 2001 with a mission to provide exceptional Third-Party Administration services to Multi-Employer (Taft-Hartley) Employee Benefit Plan Trust Funds. PAI has been awarded one of Hawaii Business Magazine's Best Places to Work for 2026 and is Hawaii`s Largest Locally Owned & Operated Third-Party Administrator.

About the Role

The Claims Processor I will work under the Claims Department Supervisor to process all medical, hospital, vision, chiropractic and ancillary claims, which includes coordination of benefit and third-party liability claims in accordance with department policies and procedures.

Responsibilities:

• 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
• Occasional carrying, loading and transporting of supplies
• Perform other duties as assigned

Requirements:

• Minimum of (2) year work experience or equivalent (combination of education and work)
• Type 45 WPM
• 10-key by Touch
• Computer literate in Word and Excel and other Microsoft applications
• Good organization skills and able to handle multi tasks
• Good analytical skills
• Self-starter and quick learner

Nice to Haves:

• Knowledge of ICD-9, ICD-10, CPT, HCPCS, FORM 1500, and UB04 forms, Medical and Revenue Coding, and Medical Terminology is a plus

Working Conditions:

• PAI offices are indoors & air-conditioned while conditions may vary at client locations
• Monday to Friday, 8:00 - 4:00 PM or 8:30 AM - 4:30 PM, with a 1-hour unpaid lunch
• The duties assigned will have situations that will require extra time

Benefits

• Medical, Dental, Vision Insurance & Prescription Drug Coverage - 100% of Employee's Medical Insurance premiums are paid for by the company for a single participant (or 50% of Employee + Dependents total premiums)
• Paid Vacation, Sick and Personal Time
• 401(k) Plan with Company Match
• Commuter Benefit - 50% of the cost of monthly Bus pass or 50% of parking is paid for by the company
• Monthly Movie Days
• Flexible Spending Account
• Group Life Insurance