HMSA

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Data Entry (Provider, ROC-1 year from DOH) - Kapolei and Honolulu

at HMSA

Posted: 10/2/2019
Job Reference #: 5000481961806
Keywords:

Job Description

Employment Type

Full Time - Regular-On-Contract

Exempt or Non-Exempt

Non-exempt

Job Summary

***Regular-on-Contract (ROC) One Year from Date of Hire***
 
Location available at either worksite: Kapolei or Honolulu.

Coordinate database updates of all provider enrollment and maintenance activities within a centralized repository and update provider information in multiple databases to support claims processing and the company's provider data needs. This requires basic working knowledge of HMSA's business, the provider databases and some understanding of claims processing.

***Regular-on-Contract (ROC) One Year from Date of Hire***

Minimum Qualifications

  1. High School diploma and one (1) year of work experience, or an equivalent combination of education and related work experience.
  2. Basic working knowledge of Microsoft Office applications.

Duties and Responsibilities

  1. Analyze and interpret basic to intermediate requests from providers and HMSA Representatives to identify provider needs, in order to update provider information in multiple databases, including claims processing databases, accurately and timely.
  2. Update Centralized provider repository and the claims processing databases after the analysis has been completed from the source requests, following HMSA business rules and practices; regulatory requirements; and other guidelines as directed.
  3. Interact with providers via phone, email or written correspondence, in a professional, knowledgeable and timely manner to obtain required documentation and clarification on provider requests; to provide status on requests that are in process; and to provide direction in support of the provider maintenance request completion.
  4. Receive and respond, as appropriate, to inquiries from providers and HMSA Representatives which are submitted to PDA via mail, email, phone and fax. Document receipt of the request in Centralized provider repository database. Assign request to the appropriate HMSA staff.
  5. Resolve discrepancies between databases and update databases if necessary.
  6. Provide quality assurance by reviewing the coding and loading of fellow PDS.
  7. Assist in special projects, attend meetings as directed by the supervisor, and write or help update desk procedures based on workflow changes or updates.
  8. Perform other duties as assigned.