Claims Processor I

Pacific Administrators, Inc.

Honolulu, HI

$19 Hourly
Vision , Medical , Dental , Life Insurance , Retirement
Full-Time

Job 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 Description

Our 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.

Why Work Here?

Great benefits package; we were Best Places to Work for 15+ yrs

Our 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.