Billing and research specialist iii - (Honolulu, HI)

Display business knowledge required to independently research any member billing issue and complex group billing issues; effectively communicate (written, telephonically or in person) the outcome of the research and resolution to the issue in a timely manner. Ensure appropriate approval levels are satisfied. Adhere to all audit and compliance policies and procedures. Conducts research as requested by management for sensitive cases/situations. Represents the unit at inter- and intra-departmental engagements including but not limited to cross-functional continuous improvement initiatives. Represents HMSA at external engagements to understand a group's business issue related to billing, providing education and/or recommending improvements to resolve the issue. Analyze discrepancy reports as a result of billing or payment application differences between multiple systems. Perform updates as needed or coordinate with other units/departments to resolve the discrepancy. Perform other duties as assigned.