| Company: | Hawaii Medical Service Assn. |
| Job Title: | Provider Service Representative I (QUEST) - Kapolei OR HMSA Center (town) |
| Exempt or Non-Exempt: | Non-Exempt |
| Island: | Oahu |
| City: | Kapolei |
| Location: | Kapolei |
| Employment Type: | Full Time - Regular-On-Contract |
| Job Summary: | *(ROC) Regular-on-Contract until 12/31/2014**
To respond to telephone and written inquiries from providers timely and accurately to expedite claims processing activities, help providers manage patient care balancing cost and quality, ensure appropriate utilization and access to care and reduce providers’ administrative burdens. |
| Duties and Responsibilities: |
- Respond to provider inquiries via telephone or in writing relative to eligibility, claims status (including expediting claims payment), provider payment report for routine and non-routine inquiries.
- Educate providers requiring more persuasion on proper completing of claims information and program procedures.
- Perform telephone contact with providers to obtain missing, discrepant or incomplete claim information.
- Receive, research and refer to appropriate area providers’ grievances and complaints on non-compliant patients, high risk catastrophic cases and special needs cases.
- Provide walk-in servicing.
- Perform other duties as needed.
|
| Minimum Qualifications: |
- High school diploma or equivalent.
- Six months experience or training in customer servicing.
- Good verbal and written communication skills.
|
0 comments:
Post a Comment