Hawaii Medical Service Association File Maintenance Specialist Trainee in Kapolei, Hawaii

Company:Hawaii Medical Service Assn.Job Title:File Maintenance Specialist TraineeExempt or Non-Exempt:Non-ExemptIsland:OahuCity:KapoleiLocation:KapoleiEmployment Type:Full TimeJob Summary:Responsible for applying business knowledge and skills to ensure timely and accurate updates of all QUEST Integration (QI) provider enrollment and maintenance activities within a centralized repository in accordance with established standards and applicable government regulations, update provider information in multiple databases which support claims processing, provider and member services and corporate data, interact with providers via phone, email or written correspondence, and respond to provider related inquiries. Performs a variety of duties related to provider data maintenance, while achieving department goals for production and accuracy. This includes but is not limited to increasing the level of automation, problem identification and resolution, improving work-flows and procedures, develop and revise appropriate documentation, and support testing needs related to providers. You will be assigned to support the team with daily production tasks, special projects and assignments of low complexity. You will serve as a team player and role model for other employees in the organization by always exhibiting traits of courtesy, caring, helpfulness, and respect. You will conduct yourself in a service-oriented manner that is attentive, pleasant, cooperative, sensitive, respectful, and kind when dealing with members, visitors, the public, and all employees.Duties and Responsibilities:

  • Provider Data Quality Assurance:

  • Learn to perform assignments based on established policies, procedures, practices, methods and instructions related to the file maintenance process. Monitors, audits, evaluate and make corrections to QI provider data in a timely manner to prevent claims errors, billing discrepancies and customer service issues.

  • Learn to gather, compute, compile, and enter membership enrollment data for statistical reports and studies, ad hoc inquiries, tracking inventory and to provide status reports for both internal and external customers.

  • Learn to track and maintain appropriate documentation as required.

  • Learn how to communicate analysis, assessments, recommendations and completed work product through professional written and verbal reports and presentations.

  • Projects and Testing:

  • Support work on special projects or large volume data maintenance projects.

  • Support testing needs and requirements involving system enhancements or changes related to providers.

  • Learn the workflow which ensures all appropriate processes are followed and documentation is completed as required by acting as quality control checkpoint verifying standards are adhered to.

  • Teamwork and Training & Development

  • Support coordination of implementation within department, including but not limited to development of processing and procedure documentation, training materials and employee training as required.

  • Interact with other staff members both within and outside the department in the accomplishment of one’s own job duties as well as assisting others in accomplishing theirs

  • Develops and initiates team building and unity.

  • Other Duties and Functions:

  • Perform other duties and accepts responsibility as assigned.

  • Attend training as needed or assigned.

Minimum Qualifications:

  • High School Diploma or General Education Degree (GED)

  • Proficiency in Microsoft Office and the Internet

  • Occasional evening and weekend time as required to meet business needs.EEO/AA/Disability/Vets Employer