Healthcare Services Specialist II: Claims & Authorization

UHA; Honolulu (HI); On-site; USD 29,000 - 35,000; Full time

Benefits offered by this job

100% family medical insurance

20 days paid personal time off firstปี

Competitive compensation & benefits

Job summary

UHA in Honolulu, Hawaii seeks a Health Care Services Specialist II to provide administrative and customer support across the Health Care Services Department, including data analytics, contracting, provider relations, pharmacy, and clinical teams. You will process prior authorization and claims information, respond to inquiries, and maintain confidential health data.

The ideal candidate has at least two years of healthcare-related administrative experience, strong communication, and meticulous

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 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 CPC designation.

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, 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.

Skills

Customer service

Attention to detail

Multitasking

Phone communication

Time management

Education

High school diploma or equivalent

Associate's degree (preferred)

Job description

UHA in Honolulu, Hawaii seeks a Health Care Services Specialist II to provide administrative and customer support across the Health Care Services Department, including data analytics, contracting, provider relations, pharmacy, and clinical teams. You will process prior authorization and claims information, respond to inquiries, and maintain confidential health data.

The ideal candidate has at least two years of healthcare-related administrative experience, strong communication, and meticulous