Hawaii Medical Service Association Business Specialist I (Government Plans) in Honolulu, Hawaii

Company:Hawaii Medical Service Assn.Job Title:Business Specialist I (Government Plans)Exempt or Non-Exempt:Non-ExemptIsland:OahuCity:HonoluluLocation:HonoluluEmployment Type:Full Time - Regular-On-ContractJob Summary:(ROC) Regular-on-Contract Two Years from Date of Hire

Coordinate and conduct auditing of enrollment records received manually and/or through automation for government lines of business to ensure data integrity and compliance with applicable laws, regulations, contractual performance standards as well as functional policies and procedures. Assist in tracking, researching all systems utilized, and reconciling monthly reports on enrollment and disenrollment related activities.Duties and Responsibilities:Ensure enrollment processing activities are in compliance with applicable laws, regulations, contractual performance standards, and functional policies and procedures.Audit/validate enrollment records and related activities to ensure accuracy, completeness and timelinessEvaluate and audit work to ensure correct knowledge/understanding of policies, process and/or procedures.Analyze results and recommend controls and/or procedure changes to ensure quality and performance standards are met.Assist with the analysis and reconciliation of internal and external enrollment reports across the various systems/applications utilized as well as in the timely and accurate completion of reports required by Centers for Medicare and Medicaid Services (CMS), executives and other management staff.

  • Perform other duties as assigned.Minimum Qualifications:Bachelor’s degree or equivalent combination of education and related work experience.Strong verbal and written communication skills.Good time and priority management skills.Good problem solving skills.Proficient working knowledge of Microsoft Office applications.

EEO/AA/Disability/Vets Employer