Operations Coordinator I

HMSA
United States, Hawaii, Kapolei
April 30, 2024
Coordinate and monitor daily workload of MM operations staff to ensure all applicable performance standards/expectations are met. Act as primary point of contact and back up for certain tasks as assigned. Evaluate and document the accuracy of various work processes through monitoring/audits. Identify training needs and report to management. Develop, document, and communicate workable, positive solutions, processes, and/or workflows taking into account regulatory, accreditation, service level agreements and the "whole" company perspective. Handle non-routine inquiries/requests and write/audit provider and member letters. Coordinate and/or conduct department and inter-departmental activities related to claim recoupment and replacement for cost savings/cost avoidance. Ensure that MM systems are updated accurately and timely and review relevant reports. Provide accurate and timely information to MM operations staff on new and updated processes/procedures/workflows. Document and disseminate materials to staff. Other duties as assigned. #LI-Hybrid