Health Care Services Specialist II

ADP, Inc.; Honolulu (HI); On-site; USD 44,000 - 53,000; Full time

Benefits offered by this job

100% family medical insurance

20 days paid personal time off during

Competitive benefits

Job summary

UHA is seeking a Health Care Services Specialist II to support the Health Care Services Department across Data Analytics, Contracting, Provider Relations, Pharmacy, and Clinical Teams. You will process prior authorization and claims information, respond to inquiries, prepare correspondence, and safeguard confidential clinical data.

The ideal candidate is organized, detail-oriented, service-focused, and thrives in a fast-paced healthcare environment, communicating professionally with members and

Qualifications

• High school diploma or equivalent.
• At least two years of administrative or clerical experience, preferably in a healthcare-related setting.
• Strong customer service and communication skills.
• Excellent attention to detail, organization, and accuracy.
• Ability to manage multiple priorities and meet time-sensitive deadlines.
• Comfortable communicating with members and provider offices by phone.
• Ability to handle confidential and sensitive information appropriately.

Responsibilities

• Process and review prior authorization requests and hospital admission information for accuracy and completeness.
• Respond to incoming calls from members and provider offices with professionalism and timely assistance.
• Research member and provider inquiries and coordinate with the appropriate team to help resolve issues.
• Process time-sensitive faxes, provider portal requests, claim reviews, and other Health Care Services documentation.
• Prepare letters and other written communications related to completed clinical reviews.
• Maintain accurate electronic records while protecting confidential health information.
• Support the Clinical Team with daily inpatient hospital census information and other administrative needs.
• Assist with department correspondence, reports, educational materials, policies, procedures, and special projects.
• Collaborate with other UHA departments and serve as a resource for Health Care Services-related questions.

Skills

Customer service

Communication

Attention to detail

Organization

Multitasking

Education

Associate’s degree

Job description

Health Care Services Specialist II

4 days ago Requisition ID: 1513

Salary Range: $21.19 To $25.42 Annually

Full-Time: Non- Exempt

Salary Range: $21.19 - $25.42/hr

We focus on your health and pay 100% for your family's medical insurance and provide 20 days of paid personal time off during your first year!

General Description of Position

The Health Care Services Specialist II provides administrative and customer service support to UHA’s Health Care Services Department, including the Data Analytics, Contracting, Provider Relations, Pharmacy, and Clinical Teams. This position supports members and providers by processing prior authorization and claims-related information, responding to inquiries, preparing correspondence, and maintaining confidential clinical information. The ideal candidate is organized, detail-oriented, service-focused, and comfortable working in a fast-paced healthcare environment.

What You’ll Do

• Process and review prior authorization requests and hospital admission information for accuracy and completeness.
• Respond to incoming calls from members and provider offices with professionalism, empathy, and timely assistance.
• Research member and provider inquiries and coordinate with the appropriate team to help resolve issues.
• Process time-sensitive faxes, provider portal requests, claim reviews, and other Health Care Services documentation.
• Prepare letters and other written communications related to completed clinical reviews.
• Maintain accurate electronic records while protecting confidential and sensitive health information.
• Support the Clinical Team with daily inpatient hospital census information and other administrative needs.
• Assist with department correspondence, reports, educational materials, policies, procedures, and special projects.
• Collaborate with other UHA departments and serve as a resource for Health Care Services-related questions.

What We’re Looking For

• High school diploma or equivalent.
• At least two years of administrative or clerical experience, preferably in a healthcare-related setting.
• Strong customer service and communication skills.
• Excellent attention to detail, organization, and accuracy.
• Ability to manage multiple priorities and meet time-sensitive deadlines.
• Comfortable communicating with members and healthcare provider offices by phone.
• Ability to handle confidential and sensitive information appropriately.
• Willingness and ability to learn healthcare benefits, policies, procedures, and systems.

Preferred Qualifications

• Associate’s degree from an accredited college or university.
• Administrative or clerical experience in a healthcare-related setting.
• Certified Professional Coder (CPC) designation desired.

Competitive compensation & excellent benefits offered

An Equal Opportunity Employer

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.