Claim processor jobs in Urban Honolulu, HI - 19 jobs

Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world's leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you're stepping onto a high-performing, values-driven team. Together, we're rising to the challenge of tackling some of healthcare's most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for healthcare. **You will:** + Receive and process requests for patient health information in accordance with Company and Facility policies and procedures. + Maintain confidentiality and security with all privileged information. + Maintain working knowledge of Company and facility software. + Adhere to the Company's and Customer facilities Code of Conduct and policies. + Inform manager of work, site difficulties, and/or fluctuating volumes. + Assist with additional work duties or responsibilities as evident or required. + Consistent application of medical privacy regulations to guard against unauthorized disclosure. + Responsible for managing patient health records. + Responsible for safeguarding patient records and ensuring compliance with HIPAA standards. + Prepares new patient charts, gathering documents and information from paper sources and/or electronic health record. + Ensures medical records are assembled in standard order and are accurate and complete. + Creates digital images of paperwork to be stored in the electronic medical record. + Responds to requests for patient records, both within the facility and by external sources, retrieving them and transmitting them appropriately. + Answering of inbound/outbound calls. + May assist with patient walk-ins. + May assist with administrative duties such as handling faxes, opening mail, and data entry. + Must meet productivity expectations as outlined at specific site. + May schedules pick-ups. + Other duties as assigned. **What you will bring to the table:** + High School Diploma or GED. + Ability to commute between locations as needed. + Able to work overtime during peak seasons when required. + Basic computer proficiency. + Comfortable utilizing phones, fax machine, printers, and other general office equipment on a regular basis. + Professional verbal and written communication skills in the English language. + Detail and quality oriented as it relates to accurate and compliant information for medical records. + Strong data entry skills. + Must be able to work with minimum supervision responding to changing priorities and role needs. + Ability to organize and manage multiple tasks. + Able to respond to requests in a fast-paced environment. **Bonus points if:** + Experience in a healthcare environment. + Previous production/metric-based work experience. + In-person customer service experience. + Ability to build relationships with on-site clients and customers. + Comfortable bringing new ideas, process improvement suggestions, and feedback to internal stakeholders. We are committed to building a diverse team of Datavanters who are all responsible for stewarding a high-performance culture in which all Datavanters belong and thrive. We are proud to be an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, or other legally protected status. Our compensation philosophy is to be externally competitive, internally fair, and not win or lose on compensation. Salary ranges for this position are developed with the support of benchmarks and industry best practices. We're building a high-growth, high-autonomy culture. We rely less on job titles and more on cultivating an environment where anyone can contribute, the best ideas win, and personal growth is driven by expanding impact. The range posted is for a given job title, which can include multiple levels. Individual rates for the same job title may differ based on their level, responsibilities, skills, and experience for a specific job. The estimated _salary range_ for this role is $15.00 - $18.32. _Comp target_ is between $16.00 - $17.00 for this role _At the end of this application, you will find a set of voluntary demographic questions. If you choose to respond, your responses will be_ _anonymous and_ _used to help us identify areas of improvement in our recruitment process._ _(_ _We can only see aggregate responses, not individual responses. In fact, we aren't even able to see if you've responded or not_ _.)_ _Responding is your choice and it will not be used in any way in our hiring process_ _._ Pay ranges for this job title may differ based on location, responsibilities, skills, experience, and other requirements of the role. The estimated base pay range per hour for this role is: $15-$18.32 USD To ensure the safety of patients and staff, many of our clients require post-offer health screenings and proof and/or completion of various vaccinations such as the flu shot, Tdap, COVID-19, etc. Any requests to be exempted from these requirements will be reviewed by Datavant Human Resources and determined on a case-by-case basis. Depending on the state in which you will be working, exemptions may be available on the basis of disability, medical contraindications to the vaccine or any of its components, pregnancy or pregnancy-related medical conditions, and/or religion. This job is not eligible for employment sponsorship. Datavant is committed to a work environment free from job discrimination. We are proud to be an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, or other legally protected status. To learn more about our commitment, please review our EEO Commitment Statement here (************************************************** . Know Your Rights (*********************************************************************** , explore the resources available through the EEOC for more information regarding your legal rights and protections. In addition, Datavant does not and will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay. At the end of this application, you will find a set of voluntary demographic questions. If you choose to respond, your answers will be anonymous and will help us identify areas for improvement in our recruitment process. (We can only see aggregate responses, not individual ones. In fact, we aren't even able to see whether you've responded.) Responding is entirely optional and will not affect your application or hiring process in any way. Datavant is committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities. If you need an accommodation while seeking employment, please request it here, (************************************************************** Id=**********48790029&layout Id=**********48795462) by selecting the 'Interview Accommodation Request' category. You will need your requisition ID when submitting your request, you can find instructions for locating it here (******************************************************************************************************* . Requests for reasonable accommodations will be reviewed on a case-by-case basis. For more information about how we collect and use your data, please review our Privacy Policy (**************************************** .

Investigates, adjusts, and negotiates for settlement of claims of real and personal property damage for and against the County of Hawai'i; conducts investigative work in contemplation of litigation and anticipated cases; handles personal injury cases not covered by insurance carried by the County of Hawai'i; and performs other related duties as required. There is one (1) immediate temporary full-time not-to-exceed 11/30/2028 vacancy with the Office of the Corporation Counsel - Litigation Division in Hilo. The eligible list may be used for other permanent and temporary vacancies as they arise during the life of the list. Temporary appointment may lead to conversion to permanent appointment. Examples of Duties * Determines, evaluates, and verifies the facts set forth in any claim or lawsuit filed against and by the County. * Locates, interviews, and interrogates the principals involved and/or the witnesses. * Inspects the physical evidence of damages; gathers and verifies the value of damages by asking for expert opinions when necessary; arrives at judgments of the worth of statements given by individuals. * Obtains additional, clarifying, or substantiating information, evidence, and facts. * Prepares reports on findings with recommendations. * Negotiates for the settlement of claims to the satisfaction of the principals involved. * Recommends to the Corporation Counsel the acceptance or rejection of liability by the County or action to be taken against individuals who owe the County. * Checks with the appropriate agencies to determine the assets of individuals against whom the County has claim. * Follows up on delinquent accounts by personal interview and recommends new terms or enforcement of terms based on findings. * Assists the County attorneys in the presentation of cases. * Testifies and presents supporting information in court, arbitrations, mediations, hearings, administrative hearings or any other quasi-judicial proceedings. * Assists the County attorneys in presenting evidence and producing witnesses. * As directed, works with County commissions, boards, administrators, and others in judicial or quasi-judicial hearings. * Monitors and evaluates all requests for No-Fault benefits, including medical treatment plans for compliance with appropriate laws and guidelines; recommends the approval or disapproval of payments, treatment plans, or modifications to plans. * Notifies claimant or authorized representative when No-Fault benefits are about to be or have been exhausted. * Locates missing persons. * Investigates complaints against County of Hawai'i employees. * Prepares detailed reports of investigations, analyses, findings, and recommendations; prepares other administrative reports as required. * Serves complaints, counter and/or cross claims, warrants, subpoenas, summonses, or other documents for the Office of the Corporation Counsel. * Investigates hardship cases in condemnation proceedings and workers' compensation cases. * Performs other related duties as assigned. Minimum Qualification Requirements Training and Experience: A combination of education and experience substantially equivalent to: * graduation from an accredited college or university with a baccalaureate degree (scan and attach a copy of your official transcript to your application), and * three (3) years of investigational or law enforcement work, of which * one (1) year shall have involved the investigation or the adjustment of claims relating to personal, medical, and property damages, and * possession of a valid State of Hawai`i driver's license (Class 3) or any other valid comparable driver's license at time of filing. (You will be required to submit your valid driver's license at time of hire.) Note: Foreign transcripts must be accompanied by an official credential evaluation report to determine U.S. equivalency. (Scan and attach a copy of your official credential evaluation report to your application.) Examination: All applicants who meet the minimum qualification requirements will be assigned a score of 70 points. An education and experience evaluation will be conducted based on the applicant's training, education and experience as presented in the application. Please read the minimum qualification requirements carefully. Be certain to list all pertinent training and experience, as this may be important in determining your examination score. It is essential that the applicant describe fully the duties and responsibilities of each position held, specify the date of each position held (from and to, month and year), and indicate the number of hours worked per week. Attach all required documentation (e.g. official transcript, professional license(s)/certification(s), DD-214, etc.) at the time of submitting your application. Note: In-person interviews and/or further testing in Hawai'i County may be required at the discretion of the hiring department/agency. If in-person interviews and/or further testing are required, applicants who are referred to the hiring department/agency must be available to participate in person and at their own expense at that phase of the selection process. Knowledge of: principles and practices of investigation; interviewing and interrogating methods and techniques; rules of evidence; elementary law of real property, insurance, and torts; court procedures; human relations and behavior. Ability to: interpret and apply laws and regulations; gather, analyze, and evaluate facts and settle liabilities; make sound observations and mature judgments; deal tactfully and effectively with the public and representatives of other government agencies; write accurate, clear, and concise reports. Physical Requirements: Persons seeking appointment to positions in this class must meet the health and physical condition standards deemed necessary and proper to perform the essential functions of the position with or without reasonable accommodations. Physical Effort Grouping: Light Benefits of County employment: The County of Hawai'i offers a competitive compensation package. Your total compensation is comprised of your salary and a generous range of valuable benefits, subject to eligibility requirements. * Flexible Working Arrangements: Options may include alternate work schedules (4-10) and flexible working hours. (Not all Departments/Agencies participate and not all positions are eligible.) * Vacation: Start accruing paid vacation time immediately upon hire - up to 21 days per year. * Sick Leave: Start accruing paid sick leave time immediately upon hire - up to 21 days per year. * Holidays: The County provides 13 paid holidays per year (plus General Election Day when applicable). * Training and Development: The County has a variety of training and development opportunities for employees. * County Tuition Reimbursement Program: This scholarship program rewards employees who take the initiative to advance their education and learning. * Public Service Loan Forgiveness (PSLF) Program: You may be eligible for this federal program which forgives portions of federal student loans for individuals working in public service. * Retirement Plan: The Employees' Retirement System is a qualified defined benefit public pension plan that provides retirement, disability, survivor and other benefits to all eligible full-time and part-time county employees in the State of Hawaii as well as their beneficiaries. * Deferred Compensation: Save additional money for retirement - this voluntary supplemental retirement savings plan allows for the investment of tax-deferred contributions. * Flexible Spending Plan: Use pre-tax dollars to pay for qualified dependent care and/or medical expenses, as well as insurance premiums. * Health Benefit Plans: The County of Hawai'i offers a variety of health benefit plans for eligible employees. * Employee Assistance Program (EAP): This voluntary assistance program provides employees and their family members with free professional and confidential assistance in overcoming personal and work-related problems. * Group Life Insurance: Free life insurance policy for active employees. * Credit Union Membership * Other Leaves: You may be eligible for other leaves, including Family Leave, Funeral Leave, Leave Sharing, Military Leave, Donor Leave, Victims Protection Leave, as well as leave for Parent-Teacher Conferences, Disaster Relief, Blood Bank Donations, and Jury Duty. All benefits are subject to eligibility requirements and change due to legislative actions and/or changes negotiated through collective bargaining. Please check out the benefits tab for additional information. Supplemental Information Please scan and attach these supporting documents to your on-line application, if required: * an official college transcript, * a valid driver's license, * a temporary assignment verification, * professional licenses, and/or * certificates. Veterans applying for veteran's preference points shall also scan and attach their DD-214 form and as needed, their VA claim letter to the on-line application. PLEASE APPLY IMMEDIATELY AS THIS RECRUITMENT MAY CLOSE AT ANY TIME. ELECTRONIC NOTIFICATION TO APPLICANTS: Please ensure that the email address and mobile phone number you provide is current, secure, and readily accessible to you. We will not be responsible in any way if you do not receive our emails and text messages or fail to check your email box or NEOGOV account INBOX in a timely manner. Checking your NEOGOV account INBOX daily is recommended and is the most secure method to check on notices sent to you. This is a new feature created by our vendor, NEOGOV. Please add *********************** to your contact list. Open your NEOGOV account using your user name and password. In the upper right hand corner of the account is your name, and under your name, click on INBOX to view all notices sent you. The notices will appear here in the INBOX even in the event you don't receive it on your cell phone, computer, or other electronic device. This is the best way to check and view all notices sent to you. You will receive a confirmation email upon successfully submitting your application. Failure to receive this confirmation email, indicates that your application was not submitted. APPLICATIONS MUST BE FILED ONLINE AT: *************************************************** E-mail: *********************

With a company culture rooted in collaboration, expertise and innovation, we aim to promote progress and inspire our clients, employees, investors and communities to achieve their greatest potential. Our work is the catalyst that helps others achieve their goals. In short, We Enable Possibility℠. Position Summary Arch Insurance Group Inc., AIGI, has an opening with the Claims Division on the Mid Corp Property Team as a Senior Claims Examiner, Property. In this role, the responsibilities include actively managing complex First Party Commercial Property claims focused in Hawaii and other jurisdictions throughout the United States. This candidate will need to be local to Hawaii. Responsibilities Identify and assess coverage issues, draft coverage position letters, and retain coverage counsel, when necessary, as well as review coverage counsel's opinion letters and analysis Develop and implement strategy related to coverage issues which correlate with the overall strategy of matters entrusted to the handler's care Develop and implement timely and accurate resolution strategies to ensure mitigation of indemnity and expense exposures Maintain contact with any/all associated claims carrier(s)' claims staff, business line leader, underwriter, defense counsel, program manager, and broker to communicate developments and outcomes as necessary Investigate claims and review the insureds' materials, pleadings, and other relevant documents Identify and review each jurisdiction's applicable statutes, rules, and case law Review litigation materials including depositions and expert's reports Analyze and direct risk transfer, additional insured issues, and contractual indemnity issues Retain counsel when necessary and direct counsel in accordance with resolution strategy Analyze coverage, liability and damages for purposes of assessing and recommending reserves Prepare and present written/oral reports to senior management setting forth all issues influencing evaluations and recommending reserves Travel to and from locations within the United States to attend mediations, trials, and other proceedings relevant to the resolution of the matter Negotiate resolution of claims Select and utilize structure brokers Maintain a diary of all claims, post reserves in a timely fashion, and expeditiously respond to inquiries from the insured, counsel, underwriters, brokers, and senior management regarding claims Experience & Required Skills Exceptional communication (written and verbal), evaluating, influencing, negotiating, listening, and interpersonal skills to effectively develop productive working relationships with internal/external peers and other professionals across organizational lines Strong time management and organizational skills Demonstrated ability to take part in active strategic discussions Demonstrated ability to work well independently and in a team environment Hands-on experience and strong aptitude with Microsoft Excel, PowerPoint and Word Willing and able to travel 10% Education Bachelor's degree required. 5-7+ years of work experience at an insurance company and/or insurance claims loss adjustment service provider managing property claims process supporting commercial accounts Proper & active adjuster licensing in all applicable states, Hawaii #LI-SW1 #LI-REMOTE For individuals assigned or hired to work in the location(s) indicated below, the base salary range is provided. Range is as of the time of posting. Position is incentive eligible. $97,000 - $115,000/year Total individual compensation (base salary, short & long-term incentives) offered will take into account a number of factors including but not limited to geographic location, scope & responsibilities of the role, qualifications, talent availability & specialization as well as business needs. The above pay range may be modified in the future. Arch is committed to helping employees succeed through our comprehensive benefits package that includes multiple medical plans plus dental, vision and prescription drug coverage; a competitive 401k with generous matching; PTO beginning at 20 days per year; up to 12 paid company holidays per year plus 2 paid days of Volunteer Time Offer; basic Life and AD&D Insurance as well as Short and Long-Term Disability; Paid Parental Leave of up to 10 weeks; Student Loan Assistance and Tuition Reimbursement, Backup Child and Elder Care; and more. Click here to learn more on available benefits. Do you like solving complex business problems, working with talented colleagues and have an innovative mindset? Arch may be a great fit for you. If this job isn't the right fit but you're interested in working for Arch, create a job alert! Simply create an account and opt in to receive emails when we have job openings that meet your criteria. Join our talent community to share your preferences directly with Arch's Talent Acquisition team. 14400 Arch Insurance Group Inc.

As a Coin Processor, you work with your team to maintain inventory in our cash vaults for our Loomis customers Responsibilities Count, sort, and handle coin bags weighing 50 pounds Manage the proper storage of pallets of boxed coin Previous forklift experience preferred (though not required) Requirements · Repetitiously lift, without assistance, at least 50 pounds from floor level to 3-4 foot level · Ability to move bulk coin with hand carts or manual pallet jacks · A valid firearms permit and/or ability to pass all applicable firearms and state regulated security guard card/license requirements in the state to which you are applying is required. This may include varying requirements under applicable state law (e.g., some states require an individual to have a high school diploma or GED to be eligible for a state issued security guard card/license or equivalent) Working Conditions · Work in a large area within a vault with little or no exposure to outside light · Full-time schedule can potentially consist of an average of 40 to 50 hours/week, with a minimum of 5 days during a 6-day period Essential Functions/Job QualificationsAs part of the qualification process for the Coin Processor position, a Human Performance Evaluation (HPE) is required. This evaluation requires successful completion of testing in the following areas:Lift:- 25lbs vertical lift from 10 inches to 66 inches from the floor (1X) Lift-Carry:- 18lbs vertical lift from 1 inch to 44 inches from the floor, and horizontally transfer 15ft (4X)- 18lbs vertical lift from 10 inches to 36 inches from the floor and horizontally transfer 300ft (1X)- 50lbs vertical lift from 10 inches to 36 inches from the floor and horizontally transfer 2ft (2X) Push-Pull:- Horizontally transfer 47lbs of force on a sled (single, non-dominant arm), a distance of 1ft (2X) Repetitive Coupling:- Squeeze Jamar Hand Dynamometer requiring forces up to 30lbs / both right & left hands (4X each) Benefits Loomis offers one of the most comprehensive employees benefit packages in the industry, which includes: · Vacation and Sick Time (PTO) as well as Paid Holidays · Health & Dental Insurance · Vision Insurance · 401(k) Plan · Basic Life Insurance Plan · Voluntary Life Insurance Plan · Flexible Spending and Health Savings Account · Dependent Care Account Industry leading Training and Development

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a subject matter expert by providing training, coaching, or responding to complex issues. May handle customer service inquiries and problems. **Additional Responsibilities:** Reviews pre-specified claims or claims that exceed specialist adjudication authority or processing expertise. - Applies medical necessity guidelines, determines coverage, completes eligibility verification, identifies discrepancies, and applies all cost containment. measures to assist in the claim adjudication process. - Handles phone and written inquiries related to requests for pre-approval/pre-authorization, reconsiderations, or appeals. - Ensures all compliance requirements are satisfied and all payments are made against company practices and procedures. - Identifies and reports possible claim overpayments, underpayments and any other irregularities. - Performs claim rework calculations. - Distributes work assignment daily to junior staff. - Trains and mentors claim benefit specialists.- Makes outbound calls to obtain required information for claim or reconsideration. **Required Qualifications** - New York Independent Adjuster License - Experience in a production environment. - Demonstrated ability to handle multiple assignments competently, accurately and efficiently. **Preferred Qualifications** - 18+ months of medical claim processing experience - Self-Funding experience - DG system knowledge **Education** **-** High School Diploma required - Preferred Associates degree or equivalent work experience. **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this role is: $18.50 - $42.35 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. **Great benefits for great people** We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and an **employee stock purchase plan** . + **No-cost programs for all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. + **Benefit solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ***************************************** We anticipate the application window for this opening will close on: 02/27/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

Purpose Preparation, Processing and Filing Motions, Orders, Notice of Hearing, Adequate Protection Orders, Response to Motions to Sell, Motions to Approve Loan Modification/Deferrals/Partial Claims Specific Duties, Activities and Responsibilities Review daily reports to ensure that files are handled efficiently and timely Preparation, Processing and Filing Motions, Orders, Notice of Hearing, Adequate Protection Orders, Response to Motions to Sell, Motions to Approve Loan Modification/Deferrals/Partial Claims Sending & Monitoring of Declarations/Affidavits in Support of Motions, Assignments, Meet and Confer Letters, and Motions for Client Approval Perform SCRA Searches and 48 hour Hearing Status Set up of Local Counsel and process Hearing Results Process ECF notifications and Attorney paper mail Update Client Systems Process Calls, Faxes, E-mails, Payment Histories, Disputes, Attorney Assignments and Debtor Checks Provide support to Management and attorneys Assist with additional projects as needed Job Requirements High School Diploma Previous law firm experience is preferred but not required Must have the ability to communicate with Attorneys Must have ability to interpret client systems Must be proficient in software tools including but not limited to Word, Excel, Outlook and the Internet Must be organized and multi-task oriented Must have excellent communication skills General Competency Factors Must be proficient in software tools, including but not limited to Word, Excel, Outlook, and the Internet. Must possess strong written and verbal communications skills. Must provide excellent customer service to internal and external customers Identifies and solves issues in a timely manner. Must be a team player and willing to help others in their department whenever necessary. Must be extremely organized and be able to multi-task. Conscientious with respect to work completion, deadlines, time management and attendance. Takes initiative in face of obstacles and identifies what needs to be done and takes action. Demonstrates commitment to Firm's vision, mission, and core values. Analytical and detail oriented, while working at a fast pace and capable of multi-tasking. Develops professional relationships and builds rapport with others. Overall good work ethic and willingness to adapt to change.

Claims Resolution & Support Serve as the primary liaison for complex escalated claim inquiries from providers, members, account management, and internal departments. Research and resolve complex claim discrepancies, denials, adjustments, and payment issues within established service-level agreements (SLAs). Coordinate with claims examiners, configuration, and payment integrity teams to ensure accurate claim adjudication. Document and maintain claim processing instructions and workflows to ensure accurate and efficient processing. Provide guidance and mentoring to Claims Liaison Specialists. Analysis & Reporting Perform root-cause analysis of claim errors, payment delays, and provider/member complaints. Compile and present findings to leadership with recommended solutions. Track claim trends and prepare reports on recurring issues, financial impact, and compliance risks. Stakeholder Communication Provide clear and timely communication of claim resolutions to providers, members, and internal stakeholders. Develop strong working relationships with provider relations, customer service, utilization management, and network management teams. Function as a subject-matter resource on claim workflows and policies. Process Improvement & Compliance Identify opportunities to improve claims workflows, system configuration, and provider/member experience. Participate in cross-functional workgroups to implement corrective actions and process enhancements. Ensure adherence to state, federal, and accreditation guidelines (e.g., CMS, HIPAA, NCQA). Performs all other miscellaneous responsibilities and duties as assigned or directed. #LI-Hybrid

Under the direction of the Manager, this position provides quality service and support to internal and external customers by processing transactions, answering questions, responding to inquiries and service requests in a timely and professional manner while adhering to Vault Services & Operations (VSO) standard safety requirements. High School diploma or G.E.D. Level is dependent on years of experience and size/complexity of prior positions held. Minimum 2 years in banking, cash handling, accounting or related experience. Demonstrated proficiency with personal computers in a networked environment and Microsoft applications (Outlook, Word, Excel, and PowerPoint) or similar software. Knowledge of or ability to use Bank software and systems. Ability to independently operate required equipment after training period. Demonstrated verbal and written communication skills. Analytical ability and math skills sufficient to balance cash trucks. Able to work independently with frequent interruptions. Must have effective interpersonal skills with a positive, can-do attitude focused on teamwork and partnership. Must be able to lift/transport up to 50 pounds and be able to stand for extended periods of time. Able to work flexible hours, including weekends and shift work. As a Bank of Hawaii employee, you ensure (or assist with ensuring) compliance with applicable laws, regulations, regulatory requirements and Bank policies and procedures, including but not limited to those related to Fair Banking, Anti-Money Laundering laws and regulations, Bank Secrecy Act and USA PATRIOT Act. Delivering exceptional customer experiences is at the heart of what we do at Bank of Hawaii. We listen, understand and deliver what our customers need to help them build a better tomorrow. We are an EEO/AA employer, including disability and veterans. For Bank of Hawaii's full EEO statement, please visit **************************** Provides quality service and support in a professional manner, meeting the bank's service guarantees/standards by processing (receives, verifies and balances) deposits received from customers and branches and releases orders to armored couriers. Prepares outgoing cash orders for customers and branches. Fields all communications via telephone, email, fax, or mail including customer deposit discrepancy notifications, customer inquiries and disputes and researches and resolves problems and processes customer requests. Balances cash trucks and adheres to cash handling guidelines. Assists with various validation processes, as assigned by VSO management. Ensures daily bag and reconciliation is balanced, reviewed, and completed accurately within established timeframes. Provides team support in meeting team goals and daily deadlines. Works with teammates, to maintain current working knowledge of the various functions within the department. Performs other miscellaneous job responsibilities and duties as assigned.

* Claims Resolution & Support * Serve as the primary liaison for complex escalated claim inquiries from providers, members, account management, and internal departments. * Research and resolve complex claim discrepancies, denials, adjustments, and payment issues within established service-level agreements (SLAs). * Coordinate with claims examiners, configuration, and payment integrity teams to ensure accurate claim adjudication. * Document and maintain claim processing instructions and workflows to ensure accurate and efficient processing. * Provide guidance and mentoring to Claims Liaison Specialists. * Analysis & Reporting * Perform root-cause analysis of claim errors, payment delays, and provider/member complaints. * Compile and present findings to leadership with recommended solutions. * Track claim trends and prepare reports on recurring issues, financial impact, and compliance risks. * Stakeholder Communication * Provide clear and timely communication of claim resolutions to providers, members, and internal stakeholders. * Develop strong working relationships with provider relations, customer service, utilization management, and network management teams. * Function as a subject-matter resource on claim workflows and policies. * Process Improvement & Compliance * Identify opportunities to improve claims workflows, system configuration, and provider/member experience. * Participate in cross-functional workgroups to implement corrective actions and process enhancements. * Ensure adherence to state, federal, and accreditation guidelines (e.g., CMS, HIPAA, NCQA). * Performs all other miscellaneous responsibilities and duties as assigned or directed. #LI-Hybrid * Associates degree and three years of related work experience; or equivalent combination of education and related work experience. * Effective written and verbal communication skill, including the ability to communicate and present complex issues in a concise and easy to understand manner. * Knowledge of process improvement methodologies. * Knowledge of methodologies for driving increased operational quality. * Intermediate knowledge of Microsoft Office applications including, but not limited to Word, Powerpoint, Outlook and Excel.

This job reviews, evaluates, and processes various Stop Loss (Excess Risk and Reinsurance) claims in accordance with established turnaround and quality standards. Responsible for building positive client relationships, providing education, and analyzing client claim losses as well as current issues regarding client activities; disseminates necessary information to the management. Follows up on pended claims in accordance with department standards. HNAS (Health Now Administrative Services) offers flexible, cost-effective solutions for employee health benefits. HNAS is part of Highmark Health, a national blended health organization with a mission to create remarkable health experiences. Our culture is built on your growth and development, collaborating across our organization, and making a big impact for those we serve. **ESSENTIAL RESPONSIBILITIES** + Processes daily incoming Stop Loss claims including initial entry claims or subsequent claims as needed; provides counseling to clients and assists with client service programs. + Evaluates various claims submitted by Third Party Administrators (TPAs) and Pharmacy Benefit Managers (PBMs) on behalf of self-funded clients for compliance with the following: underlying policy provisions, federal and state regulatory guidelines, and industry standards. + Monitors, reviews and analyzes various complex potential claims with emphasis on controlling losses through effective managed care. This includes following a departmental claim checklist to ensure eligibility is met, the payment reimbursement request is accurate by auditing the claim for duplicate line-item charges and determining if all information is available to finalize the payment request. Refers the claim to the cost containment and RxOps departments for review of high dollar charges if applicable. + Determines whether to pend or adjudicate claims following organizational policies and procedures; finalizes and adjudicates claims up to pre-determined dollar threshold. Completes pended claim letters for incomplete, invalid, or missing claim information to TPAs, brokers, or customers utilizing the appropriate application and/or template. + Identifies potential discrepancies in claim submissions and involves the Special Investigation Unit as necessary. Identifies issues which can be used to educate/train internal staff, streamline, and improve processes and update documentation. + Assists leadership with performing client performance evaluations to assess the accuracy of client reports submitted to the organization, efficiency of claim operations, and adequacy of systems and procedures. + Approves claim payments on behalf of multiple clients and provides client counseling and support services. Assists in the client service programs including revising and establishing procedures, protocols and ensuring client satisfaction with the organization. + Maintains accurate claim records. + Other duties as assigned or requested. **EDUCATION** **Required** + High School Diploma/GED **Substitutions** + None **Preferred** + Bachelor's degree **EXPERIENCE** **Required** + 5 years of relevant, progressive experience in health insurance claims + 3 years of prior experience processing 1st dollar health insurance claims + 3 years of experience with medical terminology **Preferred:** + 3 years of experience in a Stop Loss Claims Analyst role. **SKILLS** + Ability to communicate concise accurate information effectively. + Organizational skills + Ability to manage time effectively. + Ability to work independently. + Problem Solving and analytical skills. **Language (Other than English):** None **Travel Requirement:** 0% - 25% **PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS** **Position Type** Office-based Teaches / trains others regularly Occasionally Travel regularly from the office to various work sites or from site-to-site Rarely Works primarily out-of-the office selling products/services (sales employees) Never Physical work site required Yes Lifting: up to 10 pounds Constantly Lifting: 10 to 25 pounds Occasionally Lifting: 25 to 50 pounds Rarely **_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._ **_Compliance Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies._ _As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._ _Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._ **Pay Range Minimum:** $22.71 **Pay Range Maximum:** $35.18 _Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._ Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at ***************************** California Consumer Privacy Act Employees, Contractors, and Applicants Notice Req ID: J273755

Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world's leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you're stepping onto a high-performing, values-driven team. Together, we're rising to the challenge of tackling some of healthcare's most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for healthcare. + **This is a Remote role** **- Full-Time: Monday- Thursday 6:00 AM - 5:00 PM** **- Comfortable working in a high-volume production environment.** **- Processing medical record requests by taking calls from patients, insurance companies and attorneys to provide medical record status** **- Documenting information in multiple platforms using two computer monitors.** **- Proficient in Microsoft office (including Word and Excel)** **We offer:** **Comprehensive onsite/virtual training program followed by job shadowing with an assigned mentor** **Company equipment will be provided to you (including computer, monitor, virtual phone, etc.)** **Full Benefits: PTO, Health, Vision, and Dental Insurance and 401k Savings Plan and tuition Assistance** Pay ranges for this job title may differ based on location, responsibilities, skills, experience, and other requirements of the role. The estimated base pay range per hour for this role is: $15-$18.32 USD To ensure the safety of patients and staff, many of our clients require post-offer health screenings and proof and/or completion of various vaccinations such as the flu shot, Tdap, COVID-19, etc. Any requests to be exempted from these requirements will be reviewed by Datavant Human Resources and determined on a case-by-case basis. Depending on the state in which you will be working, exemptions may be available on the basis of disability, medical contraindications to the vaccine or any of its components, pregnancy or pregnancy-related medical conditions, and/or religion. This job is not eligible for employment sponsorship. Datavant is committed to a work environment free from job discrimination. We are proud to be an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, or other legally protected status. To learn more about our commitment, please review our EEO Commitment Statement here (************************************************** . Know Your Rights (*********************************************************************** , explore the resources available through the EEOC for more information regarding your legal rights and protections. In addition, Datavant does not and will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay. At the end of this application, you will find a set of voluntary demographic questions. If you choose to respond, your answers will be anonymous and will help us identify areas for improvement in our recruitment process. (We can only see aggregate responses, not individual ones. In fact, we aren't even able to see whether you've responded.) Responding is entirely optional and will not affect your application or hiring process in any way. Datavant is committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities. If you need an accommodation while seeking employment, please request it here, (************************************************************** Id=**********48790029&layout Id=**********48795462) by selecting the 'Interview Accommodation Request' category. You will need your requisition ID when submitting your request, you can find instructions for locating it here (******************************************************************************************************* . Requests for reasonable accommodations will be reviewed on a case-by-case basis. For more information about how we collect and use your data, please review our Privacy Policy (**************************************** .

Exemption Status:United States of America (Non-Exempt)$17.92 - $22.85 - $27.78 “Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, education, qualifications, and other factors. A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate.” This position is not eligible for Sponsorship. MedImpact Healthcare Systems, Inc. is looking for extraordinary people to join our team! Why join MedImpact? Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity, high performance, and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare. At MedImpact, we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of health care. We provide superior outcomes to those we serve through innovative products, systems, and services that provide transparency and promote choice in decision making. Our vision is to set the standard in providing solutions that optimize satisfaction, service, cost, and quality in the healthcare industry. We are the premier Pharmacy Benefits Management solution! Job Description Summary The successful candidate will work as a member of the Claims Processing team, ensuring accurate and timely processing of Physician, Facility, Dental, and Vision claims for multiple plan designs, including traditional PPO plans, Reference Based Pricing (RBP) plans, and Minimal Essential Coverage (MEC) plans. Interprets schedules of benefits and plan documents to apply accurate benefits to claims according to the plan design. Applies internal policy and procedures for claims adjudication, identifies and resolves claim processing errors, adjusts previously processed claims, and logs refunds for claim overpayments. Performs data entry of CMS 1500, UB 04, and dental claims, research claim issues, and assists in audit projects. Works under general supervision, relying on instructions, work process guidelines, policies & procedures, and company knowledge/experience to perform job functions, with supervision ranging from close to minimal oversight based on demonstrated skill and performance levels. Essential Duties and Responsibilities include the following. Other duties may be assigned. Accurate and timely processing of Physician, Facility, Dental and Vision claims for multiple plan designs, including traditional PPO plans, Reference Based Pricing (RBP) plans and Minimal Essential Coverage (MEC) plans. Adhere to Corporate and Departmental standards including production and quality goals. Interpret schedule of benefits and plan documents to apply accurate benefits to claims according to the plan design. Identify potential system or plan design issues that would impact the correct adjudication of a claim. Effectively communicate with the Management team on claim processing questions and issues. Interpretation and application of internal policy and procedures for claims adjudication. Identify and resolve the root cause of a claim processing and/or data entry error. Adjust previously processed claims. Identify claim over payments and log refunds. Data entry of CMS 1500, UB 04, and dental claims. Research complex claim issues. Assist in audit projects Supervisory Responsibilities No supervisory responsibilities Client Responsibilities This is an internal and external client facing position that requires excellent customer service skills and interpersonal communication skills (listening/verbal/written). One must be able to; manage difficult or emotional client situations; Respond promptly to client needs; Solicit client feedback to improve service; Respond to requests for service and assistance from clients; Meet commitments to clients. Qualifications To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Education and/or Experience GED/HS Diploma and 1+ year experience or equivalent combination of education and experience Computer Skills Intermediate knowledge of MS Office/Word, Excel, PowerPoint and Outlook. Experience with Windows based database programs is preferred. Strong aptitude for new programs. Certificates, Licenses, Registrations Certified Claims Professional (CCP), Medical Billing and Coding Certificate, or Certified Professional Coder (CPC) not required but highly preferred. Other Skills and Abilities Demonstrated ability to appear for work on time, follow directions from a supervisor, interact well with co-workers, understand and follow work rules and procedures, comply with corporate policies, goals and objectives, accept constructive criticism, establish goals and objectives, and exhibit initiative and commitment. Reasoning Ability Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form. Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Mathematical Skills Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations. Ability to add and subtract two digit numbers and to multiply and divide with 10's and 100's. Ability to perform these operations using units of American money and weight measurement, volume, and distance. Language Skills Ability to read and comprehend simple instructions, short correspondence, and memos. Ability to write simple correspondence. Ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization. Competencies To perform the job successfully, an individual should demonstrate the following competencies: Composure Decision Quality Organizational Agility Problem Solving Customer Focus Drive for Results Peer Relations Time Management Dealing with Ambiguity Learning on the Fly Political Savvy Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this Job, the employee is regularly required to sit and talk or hear. The employee is regularly required to stand; walk; use hands to finger, handle, or feel and reach with hands and arms. The employee must occasionally lift and/or move up to 25 pounds. Work Environment The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This position may regularly be exposed to or encounter moving mechanical parts, high, precarious places, fumes or airborne particles, toxic or caustic chemicals, outdoor weather conditions, risk of electrical shock or vibration. The noise level in the work environment is usually moderate (examples: business office with computers and printers, light traffic). Work Location This position must work on-site at the Honolulu, Hawaii location for purposes of providing adequate support to internal clients; being available for face-to-face interactions and coordination of work with other employees, colleagues, clients, or vendors; as well as for facilitation of quick and effective decisions through collaboration with stakeholders. Remote work is not an option for these purposes. Working Hours This is a full-time non-exempt position requiring one to be able to work overtime from time to time in order to get the job done. Therefore, one must have the ability to work nights, weekends or on holidays as required. This may be changed at any time to meet the needs of the business. The typical working hours for this position are Monday through Friday from 8:00am to 5:00pm. Travel This position requires no travel however attendance may be required at various local conferences and meetings. The Perks: Medical / Dental / Vision / Wellness Programs Paid Time Off / Company Paid Holidays Incentive Compensation 401K with Company match Life and Disability Insurance Tuition Reimbursement Employee Referral Bonus To explore all that MedImpact has to offer, and the greatness you can bring to our teams, please submit your resume to ************************* MedImpact, is a privately-held pharmacy benefit manager (PBM) headquartered in San Diego, California. Our solutions and services positively influence healthcare outcomes and expenditures, improving the position of our clients in the market. MedImpact offers high-value solutions to payers, providers and consumers of healthcare in the U.S. and foreign markets. Equal Opportunity Employer, Male/Female/Disabilities/VeteransOSHA/ADA: To perform this job successfully, the successful candidate must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Disclaimer: The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.

As a Coin Processor, you work with your team to maintain inventory in our cash vaults for our Loomis customers Responsibilities Count, sort, and handle coin bags weighing 50 pounds Manage the proper storage of pallets of boxed coin Previous forklift experience preferred (though not required) Requirements * Repetitiously lift, without assistance, at least 50 pounds from floor level to 3-4 foot level * Ability to move bulk coin with hand carts or manual pallet jacks * A valid firearms permit and/or ability to pass all applicable firearms and state regulated security guard card/license requirements in the state to which you are applying is required. This may include varying requirements under applicable state law (e.g., some states require an individual to have a high school diploma or GED to be eligible for a state issued security guard card/license or equivalent) Working Conditions * Work in a large area within a vault with little or no exposure to outside light * Full-time schedule can potentially consist of an average of 40 to 50 hours/week, with a minimum of 5 days during a 6-day period Essential Functions/Job QualificationsAs part of the qualification process for the Coin Processor position, a Human Performance Evaluation (HPE) is required. This evaluation requires successful completion of testing in the following areas:Lift:- 25lbs vertical lift from 10 inches to 66 inches from the floor (1X) Lift-Carry:- 18lbs vertical lift from 1 inch to 44 inches from the floor, and horizontally transfer 15ft (4X)- 18lbs vertical lift from 10 inches to 36 inches from the floor and horizontally transfer 300ft (1X)- 50lbs vertical lift from 10 inches to 36 inches from the floor and horizontally transfer 2ft (2X) Push-Pull:- Horizontally transfer 47lbs of force on a sled (single, non-dominant arm), a distance of 1ft (2X) Repetitive Coupling:- Squeeze Jamar Hand Dynamometer requiring forces up to 30lbs / both right & left hands (4X each) Benefits Loomis offers one of the most comprehensive employees benefit packages in the industry, which includes: * Vacation and Sick Time (PTO) as well as Paid Holidays * Health & Dental Insurance * Vision Insurance * 401(k) Plan * Basic Life Insurance Plan * Voluntary Life Insurance Plan * Flexible Spending and Health Savings Account * Dependent Care Account Industry leading Training and Development

Under the supervision of Claims Supervisor, performs accurately all functions related to dental claims processing. Follows processing rules, guidelines, and policies. Meets department productivity, quality, and accountability standards. ESSENTIAL DUTIES AND RESPONSIBILITIES Key Responsibilities Electronically images hardcopy claims batch as OCR, Non-OCR, and x-ray attachments. Batch image paper attachments, POAs and adjustments, and back-end imaging of claims documentation. Inputs rejected and RFI claims notices. Performs all aspects of claims data entry, including verification of required documentations. Processes Levels 1, 2 and 3 claims consisting of single, COB-S, Dual, Pre-authorizations and out of state type claims. Reviews all levels of suspended electronic claims including opening and sorting of ECS mails. Processes requests to pay pre-authorizations. Other Duties and Responsibilities Assists the Claims department in adhering to established document policies and procedures. Provides back-up support and assistance in Customer Service and other departments as necessary. Accomplishes special projects as assigned. Determines and follows through with a plan to meet annual goals set up with the supervisor. Takes responsibility for relationships with others in the department and company. Works as a team player and assists wherever there is a need. Maintains a customer advocate attitude, understanding the importance that timely and accurate claims processing has on customer satisfaction. Other miscellaneous duties and responsibilities as assigned. MINIMUM QUALIFICATIONS AND EXPERIENCE Education High School Diploma or its equivalent required. Experience Minimum two years of clerical experience, customer service, sales, or any combination of education and experience which would provide the necessary knowledge, skills, and abilities to meet the minimum qualifications to perform the essential functions of this position. Skills and Knowledge Working knowledge of PC applications (i.e., word processing and spreadsheets) highly desirable. Requires demonstrated customer service skills and sales ability. Ability to maintain focus and attention to detail. Ability to handle multiple tasks with some distractions. Ability to communicate orally and in writing with all levels of staff, customers and vendors. Ability to handle all information in a confidential manner and in compliance with federal and state laws/regulations (i.e., HIPAA, PHI). Note : The above information in this description has been designed to indicate the general nature and level of work performed by an employee in this classification. It is not to be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications of employees assigned to this job. Hawaii Dental Service has the right to add to, revise, or delete information in this description. Reasonable accommodation will be made to enable qualified individuals with disabilities to perform the essential functions of this position.

Claims Resolution & Support Serve as the primary liaison for complex escalated claim inquiries from providers, members, account management, and internal departments. Research and resolve complex claim discrepancies, denials, adjustments, and payment issues within established service-level agreements (SLAs). Coordinate with claims examiners, configuration, and payment integrity teams to ensure accurate claim adjudication. Document and maintain claim processing instructions and workflows to ensure accurate and efficient processing. Provide guidance and mentoring to Claims Liaison Specialists. Analysis & Reporting Perform root-cause analysis of claim errors, payment delays, and provider/member complaints. Compile and present findings to leadership with recommended solutions. Track claim trends and prepare reports on recurring issues, financial impact, and compliance risks. Stakeholder Communication Provide clear and timely communication of claim resolutions to providers, members, and internal stakeholders. Develop strong working relationships with provider relations, customer service, utilization management, and network management teams. Function as a subject-matter resource on claim workflows and policies. Process Improvement & Compliance Identify opportunities to improve claims workflows, system configuration, and provider/member experience. Participate in cross-functional workgroups to implement corrective actions and process enhancements. Ensure adherence to state, federal, and accreditation guidelines (e.g., CMS, HIPAA, NCQA). Performs all other miscellaneous responsibilities and duties as assigned or directed. #LI-Hybrid

As a Coin Processor, you work with your team to maintain inventory in our cash vaults for our Loomis customers Responsibilities Count, sort, and handle coin bags weighing 50 pounds Manage the proper storage of pallets of boxed coin Previous forklift experience preferred (though not required) Requirements · Repetitiously lift, without assistance, at least 50 pounds from floor level to 3-4 foot level · Ability to move bulk coin with hand carts or manual pallet jacks · A valid firearms permit and/or ability to pass all applicable firearms and state regulated security guard card/license requirements in the state to which you are applying is required. This may include varying requirements under applicable state law (e.g., some states require an individual to have a high school diploma or GED to be eligible for a state issued security guard card/license or equivalent) Working Conditions · Work in a large area within a vault with little or no exposure to outside light · Full-time schedule can potentially consist of an average of 40 to 50 hours/week, with a minimum of 5 days during a 6-day period Essential Functions/Job QualificationsAs part of the qualification process for the Coin Processor position, a Human Performance Evaluation (HPE) is required. This evaluation requires successful completion of testing in the following areas:Lift:- 25lbs vertical lift from 10 inches to 66 inches from the floor (1X) Lift-Carry:- 18lbs vertical lift from 1 inch to 44 inches from the floor, and horizontally transfer 15ft (4X)- 18lbs vertical lift from 10 inches to 36 inches from the floor and horizontally transfer 300ft (1X)- 50lbs vertical lift from 10 inches to 36 inches from the floor and horizontally transfer 2ft (2X) Push-Pull:- Horizontally transfer 47lbs of force on a sled (single, non-dominant arm), a distance of 1ft (2X) Repetitive Coupling:- Squeeze Jamar Hand Dynamometer requiring forces up to 30lbs / both right & left hands (4X each) Benefits Loomis offers one of the most comprehensive employees benefit packages in the industry, which includes: · Vacation and Sick Time (PTO) as well as Paid Holidays · Health & Dental Insurance · Vision Insurance · 401(k) Plan · Basic Life Insurance Plan · Voluntary Life Insurance Plan · Flexible Spending and Health Savings Account · Dependent Care Account Industry leading Training and Development

By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve. Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies Certified as a Great Place to Work Fortune Best Workplaces in Financial Services & Insurance PL CLAIM SPECIALIST **PRIMARY PURPOSE** **:** To analyze complex or technically difficult medical malpractice claims; to provide resolution of highly complex nature and/or severe injury claims; to coordinate case management within Company standards, industry best practices and specific client service requirements; and to manage the total claim costs while providing high levels of customer service. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Analyzes and processes complex or technically difficult medical malpractice claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution. + Conducts or assigns full investigation and provides report of investigation pertaining to new events, claims and legal actions. + Negotiates claim settlement up to designated authority level. + Calculates and assigns timely and appropriate reserves to claims; monitors reserve adequacy throughout claim life. + Recommends settlement strategies; brings structured settlement proposals as necessary to maximize settlement. + Coordinates legal defense by assigning attorney, coordinating support for investigation, and reviewing attorney invoices; monitors counsel for compliance with client guidelines. + Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall claim cost for our clients. + Identifies and investigates for possible fraud, subrogation, contribution, recovery, and case management opportunities to reduce total claim cost. + Represents Company in depositions, mediations, and trial monitoring as needed. + Communicates claim activity and processing with the client; maintains professional client relationships. + Ensures claim files are properly documented and claims coding is correct. + Refers cases as appropriate to supervisor and management. + Delegates work and mentors assigned staff. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + Performs other duties as assigned. + Supports the organization's quality program(s). **QUALIFICATIONS** **Education & Licensing** Bachelor's degree from an accredited college or university preferred. Licenses as required. Professional certification as applicable to line of business preferred. **Experience** Six (6) years of claims management experience or equivalent combination of education and experience required. **Skills & Knowledge** + In-depth knowledge of appropriate medical malpractice insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security application procedures as applicable to line-of-business + Excellent oral and written communication, including presentation skills + PC literate, including Microsoft Office products + Analytical and interpretive skills + Strong organizational skills + Excellent negotiation skills + Good interpersonal skills + Ability to work in a team environment + Ability to meet or exceed Performance Competencies **WORK ENVIRONMENT** When applicable and appropriate, consideration will be given to reasonable accommodations. **Mental** **:** Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines **Physical** **:** Computer keyboarding, travel as required **Auditory/Visual** **:** Hearing, vision and talking _As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $117,000 - $125,000. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits._ The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time. Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. **If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**

Under the supervision of Claims Supervisor, performs accurately all functions related to dental claims processing. Follows processing rules, guidelines, and policies. Meets department productivity, quality, and accountability standards. ESSENTIAL DUTIES AND RESPONSIBILITIES Key Responsibilities Electronically images hardcopy claims batch as OCR, Non-OCR, and x-ray attachments. Batch image paper attachments, POAs and adjustments, and back-end imaging of claims documentation. Inputs rejected and RFI claims notices. Performs all aspects of claims data entry, including verification of required documentations. Processes Levels 1, 2 and 3 claims consisting of single, COB-S, Dual, Pre-authorizations and out of state type claims. Reviews all levels of suspended electronic claims including opening and sorting of ECS mails. Processes requests to pay pre-authorizations. Other Duties and Responsibilities Assists the Claims department in adhering to established document policies and procedures. Provides back-up support and assistance in Customer Service and other departments as necessary. Accomplishes special projects as assigned. Determines and follows through with a plan to meet annual goals set up with the supervisor. Takes responsibility for relationships with others in the department and company. Works as a team player and assists wherever there is a need. Maintains a customer advocate attitude, understanding the importance that timely and accurate claims processing has on customer satisfaction. Other miscellaneous duties and responsibilities as assigned. MINIMUM QUALIFICATIONS AND EXPERIENCE Education High School Diploma or its equivalent required. Experience Minimum two years of clerical experience, customer service, sales, or any combination of education and experience which would provide the necessary knowledge, skills, and abilities to meet the minimum qualifications to perform the essential functions of this position. Skills and Knowledge Working knowledge of PC applications (i.e., word processing and spreadsheets) highly desirable. Requires demonstrated customer service skills and sales ability. Ability to maintain focus and attention to detail. Ability to handle multiple tasks with some distractions. Ability to communicate orally and in writing with all levels of staff, customers and vendors. Ability to handle all information in a confidential manner and in compliance with federal and state laws/regulations (i.e., HIPAA, PHI). Note : The above information in this description has been designed to indicate the general nature and level of work performed by an employee in this classification. It is not to be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications of employees assigned to this job. Hawaii Dental Service has the right to add to, revise, or delete information in this description. Reasonable accommodation will be made to enable qualified individuals with disabilities to perform the essential functions of this position.