Claims Adjudicator I in Honolulu, Hawaii at Hawaii-Western Management Group Inc

Summary

Analyzes claims to determine the extent of the health plan’s liability and makes benefit determinations on claims in accordance with plan benefits, processing guidelines, and policy provisions.

Qualifications

• High school diploma or general education degree (GED) is required. Certificate from college or technical school; experience in medical claims processing at a health insurance company or third-party administrator; or an equivalent combination of education and experience is preferred.
• Basic-level proficiency in Microsoft Word and Excel
• Knowledge of medical terminology, CPT, ICD, and HCPCS codes
• Good organizational and decision-making skills
• Able to prioritize and consistently meet deadlines
• Strong data entry skills, 10-key by touch, and attention to detail
• Work independently and in a team environment
• Certified Professional Coder (CPC) certification is preferred

Expected Starting Salary: $37,000 - $45,000 annually. Full salary range is broader and depends on experience.