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Located in Honolulu,HI Seeking a candidate for a Receptionist opportunity with a local law firm! The ideal candidate will have one year of recent administrative experience. Responsibilities of Receptionist include handling a multi- phone line, communicating effectively with clients, coordinating mee...  More Details
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  • HMSA
  • Honolulu, HI United States
  • 04/27/2017
  • Administrative / Clerical
**(ROC) Regular-on-Contract 1 year from date of hire**Provides high level administrative and clerical support to Member Advocacy and Appeals department. Duties and Responsibilities: Handles the intake, closing and reporting processes for all Department cases that involve complex confidential issues ...  More Details
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  • HMSA
  • Honolulu, HI United States
  • 04/27/2017
  • Legal
Protects corporate assets through the detection of complex analysis and practices authorized or unauthorized, which cause unjustifiable expenditures and to pro-actively identify areas vulnerable to fraud and abuse. Work closely with law enforcement investigators to resolve these issues. Track and re...  More Details
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  • HMSA
  • Lihue, HI United States
  • 04/27/2017
  • Healthcare
Engages members admitted to the hospital into appropriate programs to increase positive collaboration outcomes with hospital clinicians and staff. Provides coordinated case management services for members from admission to post discharge by working with healthcare providers, members and families, en...  More Details
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  • HMSA
  • Honolulu, HI United States
  • 04/27/2017
Independently investigates all other party liability data (Coordination of Benefits between multiple plans, and No Fault, Workers Compensation, Third Party Liability) to ensure accuracy and compliance with health plan administration and governmental rules and regulations. Duties and Responsibilities...  More Details
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  • HMSA
  • Honolulu, HI United States
  • 04/27/2017
Investigates all other party liability data (Coordination of Benefits between multiple plans or No Fault, Workers Compensation, Third Party Liability) to ensure accuracy and compliance with health plan administration and governmental rules and regulations. Duties and Responsibilities: Investigates a...  More Details
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  • HMSA
  • Honolulu, HI United States
  • 04/27/2017
  • Healthcare
Engages members admitted to the hospital into appropriate programs to increase positive collaboration outcomes with hospital clinicians and staff. Provides coordinated case management services for members from admission to post discharge by working with healthcare providers, members and families, en...  More Details
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  • HMSA
  • Honolulu, HI United States
  • 04/27/2017
  • Legal
Manage and oversee the performance of Service Coordinators on their assigned island/territory and direct the daily Service Coordination operations related to Special Health Care Needs (SHCN) in compliance with HMSA policies, contractual standards and Federal and State law. Priority Parking - Driving...  More Details
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  • HMSA
  • Honolulu, HI United States
  • 04/27/2017
  • Administrative / Clerical
Analyze, research and develop policies, procedures and related documentation responsive to regulatory and contractual requirements. Analyze, research and develop reporting on member and provider appeals, grievances, and aspects of health plan coverage consistent with contract, regulatory and/or accr...  More Details
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  • HMSA
  • Honolulu, HI United States
  • 04/27/2017
  • Legal
Responsible for overall department timely and effective response and resolution to grievances, complex complaints and appeals that are raised by members and providers relating to all aspects of health plan coverage consistent with contract, regulatory and/or accreditation requirements. Also assists ...  More Details
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  • HMSA
  • Honolulu, HI United States
  • 04/27/2017
  • Healthcare
Manage, research and respond to member and provider appeals, complex complaints, grievances and inquiries relating to all aspects of health plan coverage consistent with contract, regulatory and/or accreditation requirements. Duties and Responsibilities: Conducts critical analysis of highly complex ...  More Details
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  • HMSA
  • Honolulu, HI United States
  • 04/27/2017
  • Administrative / Clerical
The Human Resource Support Specialist performs duties with some or all of the different functional HR areas including benefits, training, compensation and administration following established plan administration and procedures in areas such as health insurance, group life, 401(k), Section 125 plans,...  More Details
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  • HMSA
  • Honolulu, HI United States
  • 04/27/2017
  • Healthcare
Research and respond to member and provider appeals, complex complaints, grievances and inquiries relating to all aspects of health plan coverage consistent with contract, regulatory and/or accreditation requirements. Duties and Responsibilities: With guidance from management, conducts critical anal...  More Details
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  • HMSA
  • Honolulu, HI United States
  • 04/27/2017
  • Administrative / Clerical
Investigate potential Third Party Liability cases to determine primacy and ensure correct application of benefits and cost avoidance. Duties and Responsibilities: Investigate potential Third Party Liability (TPL) cases by contacting members, providers, attorneys, and other carriers for necessary inf...  More Details
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  • HMSA
  • Honolulu, HI United States
  • 04/27/2017
**(ROC) Regular-on-Contract until 12/29/17**Investigates all other party liability data (Coordination of Benefits between multiple plans or No Fault, Workers Compensation, Third Party Liability) to ensure accuracy and compliance with health plan administration and governmental rules and regulations....  More Details
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