AlohaCare
Apply online at
http://www.alohacare.org/Careers/Default.aspx
The Company AlohaCare is a local, non-profit health plan serving Hawai`i’s low-income residents with free Medicaid and dual Medicare health insurance coverage. Our members include children, seniors and adults residing on all islands. We provide comprehensive benefits and managed care services with an emphasis on healthy living habits and preventive primary health care. Our approach is to meet the whole-person health and social needs of members. Through our community partnerships we offer innovative services such as connection to social service agencies, Native Hawaiian healing services and in-home primary care for qualified members. Our mission is to serve in the true spirit of aloha by ensuring and advocating for access to quality health care for all. We are Hawaii’s third-largest health plan and offer a wide network of quality primary care, specialists, hospitals, pharmacies and among many other providers across the state.
The Culture AlohaCare employees have a passion for helping Hawai`i’s most underserved communities. Our caring culture is fundamental to our company-wide team approach to providing high quality services. We support our employees with a supportive and positive work environment, healthy work-life balance, continuous communication, and a generous benefits package. AlohaCare’s leadership empowers and engages its employees by recognizing outstanding job performance and collaboration. We share organization-wide updates during quarterly All Staff meetings. We encourage participation in volunteer and educational opportunities. We put a high value on honesty, respect, and trust-building. We encourage open-door, two-way, and frequent communication. AlohaCare’s comprehensive benefits package includes low-cost medical, dental, drug and vision insurance, paid time-off, 401k employer contribution, referral bonus and pretax transportation and parking program.
The Opportunity The Administrative Assistant will be essential in the relief of non-clinical tasks that must be carried out accurately and timely according to set policy and procedures in support of all Health Services departments in the organization. This position is key to the success of internal and external staff members in providing excellent customer service to our members and providers. Tasks will require use of critical thinking to assist the department Supervisor and/or Manager with administrative needs for special reports and other projects using clear and understandable written and verbal communication skills. The Administrative Assistant is required to complete assigned duties as this will impact the department outcomes for Health Services.
Primary Duties And Responsibilities
Assist and provide telephonic support as needed from:
Physicians and office staff
Other Service Providers
Member Inquiries (Quest & Medicare)
Arrange follow up for resolution as needed in a timely manner
Other duties as assigned per departmental or organizational needs
Assist with Daily Monitoring/Resolving/Closing out pended G8 activities for activities received from other departments.
Assist with Daily Monitoring/Printing of Administrative Assistant Print Queue.
Assist and provide written support by filling out internal forms as needed (ex. transportation requests).
Work with our computer system for care and utilization management (Altruista).
Work with our computer system for claims and enrollment (QNXT).
Creation and review of new authorizations, extensions, and continuation of existing services.
Fax and/or mail provider/member denial notification letters as directed by the nurse and create denial packets for filing.
Track and process any inpatient admission on a daily basis and update the appropriate auth owner as needed.
Monitor and process incoming faxes for various Health Services departments and if needed request for additional notes by using the Medical Information Request Form (MIRF).
Sort incoming member reimbursement requests and distribute to the appropriate department if needed.
Assist UM/MM Nurses with filing high catastrophic cases to the outlier second insurer by working collaboratively with the Financial Analyst.
Front desk coverage may be assigned for the relief of full-time receptionist, responsibilities may include, but not limited to:
Daily Mail Prep/Certified/Courier/UPS/Fed Ex
Monitor Postage/Replenish as needed
Monitor Supplies/Reorder
Mail distribution
Monitor/Respond timely to multiple interdepartmental emails/tasks
Sort/distribute incoming faxes for multiple departments
Monitoring/Resending Failed Faxes – electronically
Greeting/Signing-in Visitors w/ follow up as needed
Other administrative assistant tasks as assigned.
Ability to organize, prioritize, communicate and manage workload effectively and efficiently.
Assist with preparation, tracking and maintenance of reports necessary to carry out the functions of the department.
Prepares periodic reports for management, as necessary or requested, to track strategic goal accomplishment.
Assist with identification and reporting of possible Fraud, Waste, and Abuse cases.
All other duties assigned.
Adhere to regulatory compliance and quality guidelines as well as AlohaCare policies and procedures.
Responsible to maintain AlohaCare’s confidential information in accordance with AlohaCare policies, and state and federal laws, rules and regulations regarding confidentiality. Employees have access to AlohaCare data based on the data classification assigned to this job title.
Requirements
High school diploma or equivalent
Minimum of 1 year experience as an Administrative Assistant, Office Coordinator, or Customer Service Specialist.
Achieves results, builds trust, communicate effectively, customer and quality focused.
Strong interpersonal and facilitation skills with the ability to communicate with all levels of the organization.
Strong, effective, and precise written and oral communication skills; speak clearly and persuasively in positive or negative situations.
Professional telephonic etiquette skills.
Ability to solve problems, analyze, think critically and make good judgment.
Strong customer service skills and be able to work in a diverse, demanding and evolving environment with strong conflict and problem resolution skills.
Able to work independently with minimal supervision.
Able to effectively work in a fast-paced and changing environment, manage multiple projects and priorities across multiple teams/projects and in a matrixed environment.
Possesses excellent time management and organizational skills; is dependable, enthusiastic, self-starting, and self-motivated. Uses time effectively, reacts professionally under pressure.
Working knowledge of Microsoft Office programs: Word, Excel, Outlook and PowerPoint.
Experience in the operation of general office equipment to include PC, fax/copy machine and phone system.
Preferred Requirements
Previous experience working in the Medical or Health Plan environment.
Word Processing skills of 45-60 wpm with a high degree of accuracy with 10 Key experience.
Experience or demonstrated knowledge of medical terminology, ICD-10-CM, CPT and HCPCS codes.
Mental, Physical And Environmental Demands
Sedentary Work: Exerting up to 20 pounds of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects. Sedentary work involves sitting most of the time but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.
In office working environment.
May require prolonged sitting- up to 4 hours.
Requires prolonged operation of a computer workstation, including the ability to type for extended periods of time on a keyboard during the scheduled workday.
Salary Range: $16.50 – $19.00 an hour
AlohaCare is committed to providing equal employment opportunity to all applicants in accordance with sound practices and federal and state laws. Our policy prohibits discrimination and harassment because of race, color, religion, sex (including gender identity or expression), pregnancy, age, national origin, ancestry, marital status, arrest and court record, disability, genetic information, sexual orientation, domestic or sexual violence victim status, credit history, citizenship status, military/veteran status, or other characteristics protected under applicable state and federal laws, regulations, and/or executive orders.
Seniority level
Entry level
Employment type
Full-time
Job function
Strategy/Planning and Information Technology
Industries
Insurance
#J-18808-Ljbffr
http://www.alohacare.org/Careers/Default.aspx
The Company AlohaCare is a local, non-profit health plan serving Hawai`i’s low-income residents with free Medicaid and dual Medicare health insurance coverage. Our members include children, seniors and adults residing on all islands. We provide comprehensive benefits and managed care services with an emphasis on healthy living habits and preventive primary health care. Our approach is to meet the whole-person health and social needs of members. Through our community partnerships we offer innovative services such as connection to social service agencies, Native Hawaiian healing services and in-home primary care for qualified members. Our mission is to serve in the true spirit of aloha by ensuring and advocating for access to quality health care for all. We are Hawaii’s third-largest health plan and offer a wide network of quality primary care, specialists, hospitals, pharmacies and among many other providers across the state.
The Culture AlohaCare employees have a passion for helping Hawai`i’s most underserved communities. Our caring culture is fundamental to our company-wide team approach to providing high quality services. We support our employees with a supportive and positive work environment, healthy work-life balance, continuous communication, and a generous benefits package. AlohaCare’s leadership empowers and engages its employees by recognizing outstanding job performance and collaboration. We share organization-wide updates during quarterly All Staff meetings. We encourage participation in volunteer and educational opportunities. We put a high value on honesty, respect, and trust-building. We encourage open-door, two-way, and frequent communication. AlohaCare’s comprehensive benefits package includes low-cost medical, dental, drug and vision insurance, paid time-off, 401k employer contribution, referral bonus and pretax transportation and parking program.
The Opportunity The Administrative Assistant will be essential in the relief of non-clinical tasks that must be carried out accurately and timely according to set policy and procedures in support of all Health Services departments in the organization. This position is key to the success of internal and external staff members in providing excellent customer service to our members and providers. Tasks will require use of critical thinking to assist the department Supervisor and/or Manager with administrative needs for special reports and other projects using clear and understandable written and verbal communication skills. The Administrative Assistant is required to complete assigned duties as this will impact the department outcomes for Health Services.
Primary Duties And Responsibilities
Assist and provide telephonic support as needed from:
Physicians and office staff
Other Service Providers
Member Inquiries (Quest & Medicare)
Arrange follow up for resolution as needed in a timely manner
Other duties as assigned per departmental or organizational needs
Assist with Daily Monitoring/Resolving/Closing out pended G8 activities for activities received from other departments.
Assist with Daily Monitoring/Printing of Administrative Assistant Print Queue.
Assist and provide written support by filling out internal forms as needed (ex. transportation requests).
Work with our computer system for care and utilization management (Altruista).
Work with our computer system for claims and enrollment (QNXT).
Creation and review of new authorizations, extensions, and continuation of existing services.
Fax and/or mail provider/member denial notification letters as directed by the nurse and create denial packets for filing.
Track and process any inpatient admission on a daily basis and update the appropriate auth owner as needed.
Monitor and process incoming faxes for various Health Services departments and if needed request for additional notes by using the Medical Information Request Form (MIRF).
Sort incoming member reimbursement requests and distribute to the appropriate department if needed.
Assist UM/MM Nurses with filing high catastrophic cases to the outlier second insurer by working collaboratively with the Financial Analyst.
Front desk coverage may be assigned for the relief of full-time receptionist, responsibilities may include, but not limited to:
Daily Mail Prep/Certified/Courier/UPS/Fed Ex
Monitor Postage/Replenish as needed
Monitor Supplies/Reorder
Mail distribution
Monitor/Respond timely to multiple interdepartmental emails/tasks
Sort/distribute incoming faxes for multiple departments
Monitoring/Resending Failed Faxes – electronically
Greeting/Signing-in Visitors w/ follow up as needed
Other administrative assistant tasks as assigned.
Ability to organize, prioritize, communicate and manage workload effectively and efficiently.
Assist with preparation, tracking and maintenance of reports necessary to carry out the functions of the department.
Prepares periodic reports for management, as necessary or requested, to track strategic goal accomplishment.
Assist with identification and reporting of possible Fraud, Waste, and Abuse cases.
All other duties assigned.
Adhere to regulatory compliance and quality guidelines as well as AlohaCare policies and procedures.
Responsible to maintain AlohaCare’s confidential information in accordance with AlohaCare policies, and state and federal laws, rules and regulations regarding confidentiality. Employees have access to AlohaCare data based on the data classification assigned to this job title.
Requirements
High school diploma or equivalent
Minimum of 1 year experience as an Administrative Assistant, Office Coordinator, or Customer Service Specialist.
Achieves results, builds trust, communicate effectively, customer and quality focused.
Strong interpersonal and facilitation skills with the ability to communicate with all levels of the organization.
Strong, effective, and precise written and oral communication skills; speak clearly and persuasively in positive or negative situations.
Professional telephonic etiquette skills.
Ability to solve problems, analyze, think critically and make good judgment.
Strong customer service skills and be able to work in a diverse, demanding and evolving environment with strong conflict and problem resolution skills.
Able to work independently with minimal supervision.
Able to effectively work in a fast-paced and changing environment, manage multiple projects and priorities across multiple teams/projects and in a matrixed environment.
Possesses excellent time management and organizational skills; is dependable, enthusiastic, self-starting, and self-motivated. Uses time effectively, reacts professionally under pressure.
Working knowledge of Microsoft Office programs: Word, Excel, Outlook and PowerPoint.
Experience in the operation of general office equipment to include PC, fax/copy machine and phone system.
Preferred Requirements
Previous experience working in the Medical or Health Plan environment.
Word Processing skills of 45-60 wpm with a high degree of accuracy with 10 Key experience.
Experience or demonstrated knowledge of medical terminology, ICD-10-CM, CPT and HCPCS codes.
Mental, Physical And Environmental Demands
Sedentary Work: Exerting up to 20 pounds of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects. Sedentary work involves sitting most of the time but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.
In office working environment.
May require prolonged sitting- up to 4 hours.
Requires prolonged operation of a computer workstation, including the ability to type for extended periods of time on a keyboard during the scheduled workday.
Salary Range: $16.50 – $19.00 an hour
AlohaCare is committed to providing equal employment opportunity to all applicants in accordance with sound practices and federal and state laws. Our policy prohibits discrimination and harassment because of race, color, religion, sex (including gender identity or expression), pregnancy, age, national origin, ancestry, marital status, arrest and court record, disability, genetic information, sexual orientation, domestic or sexual violence victim status, credit history, citizenship status, military/veteran status, or other characteristics protected under applicable state and federal laws, regulations, and/or executive orders.
Seniority level
Entry level
Employment type
Full-time
Job function
Strategy/Planning and Information Technology
Industries
Insurance
#J-18808-Ljbffr