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TEKsystems

Case Resolution Specialist - Medical Insurance $22/h WEEKLY PAY

TEKsystems, Honolulu, Hawaii, United States, 96814

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Overview

Case Resolution Specialist - Medical Insurance $22/h WEEKLY PAY at TEKsystems Responsibilities

Conduits critical analysis of highly complex and sensitive member and provider appeals, inquiries and grievances and applies internal policies and procedures, contractual provisions, and regulatory requirements. Takes all facts and research from internal and external resources and presents a full explanation of the member's or provider's position and concerns to management and decision makers. Assists Supervisor and Coordinator in acting as a liaison with providers, members and internal decision makers in representing HMSA objectives, goals, and expectations for meeting contractual, regulatory, and accreditation requirements. Identifies member problems, education needs, or trends and reports them to the manager; takes a proactive role in reviewing and communicating new regulations, standards, or business changes affecting the member advocacy and/or appeals process. At management direction, assists in coordinating changes among departments. Qualifications

Bachelor\'s degree and one year of related work experience; or equivalent combination of education and related work experience Effective verbal and written communication skills Problem identification and resolution skills Basic knowledge of Microsoft Office applications (Word, Excel, Outlook, PowerPoint) Preferred

Experience in the healthcare industry Experience with customer servicing Strong critical thinking and problem-solving skills Pay and Benefits

Pay range: $22.00 - $23.00/hr Benefits may include Medical, dental & vision; life insurance; disability; 401(k) options; HSA; transportation benefits; EAP; PTO/vacation/sick leave Workplace Type

This is a fully onsite position in Honolulu, HI. Application Details

This position is anticipated to close on Oct 13, 2025. About TEKsystems

TEKsystems is an Allegis Group company and an equal opportunity employer. We partner in transformation with clients across North America, Europe and Asia. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com.

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