Hybrid Provider Services Research Coordinator – Oahu

Hawaii Medical Service Association; Honolulu (HI); Hybrid; USD 48,000 - 88,000; Full time

Job summary

Hawaii Medical Service Association (HMSA) on Oahu seeks a Provider Services professional to coordinate resolution of providers' issues, including reimbursement, claims processing, and medical and payment policies. You will communicate resolutions directly with providers and participate in cross-department workgroups representing HMSA's Provider Services Department.

The role requires effective verbal and written communication, and basic Microsoft Office skills.

Qualifications

• Bachelor's degree and two years related work experience; or an equivalent combination of education and related work experience.
• Effective verbal and written communication skills.
• Basic working knowledge of Microsoft Office applications including but not limited to Word and Outlook/Email.

Responsibilities

• Coordinates case resolution with internal business areas to respond timely and accurately to provider inquiries regarding claims, benefits and medium complex issues that include medical, or payment policy questions and provider appeals.
• Participates on cross department workgroups representing Provider Services Department. Coordinates system issue resolution and facilitates communications about core system changes and issues.
• Develops education and training material for providers and their staff including workshop presentations and written educational material.
• Coordinates and maintains Provider Servicing staff training program and develops success measurement activities.
• Develops, implements and maintains Department workflows and procedures; participates in process improvements for greater operational efficiency.
• Performs all other miscellaneous responsibilities and duties as assigned or directed.

Skills

Verbal and written communication

Education

Bachelor's degree with 2 years experience

Tools

Microsoft Word

Outlook/Email

Microsoft Office

Job description

Hawaii Medical Service Association (HMSA) on Oahu seeks a Provider Services professional to coordinate resolution of providers' issues, including reimbursement, claims processing, and medical and payment policies. You will communicate resolutions directly with providers and participate in cross-department workgroups representing HMSA's Provider Services Department.

The role requires effective verbal and written communication, and basic Microsoft Office skills.