HMSA

Quality Assurance Trainer II - Bluecard

HMSA  •  Kapolei, HI (Onsite)  •  4 hours ago
Apply
Save Job
Mark Applied Mark Interviewed Mark Offered
Hide Job Report Job
AI can make mistakes so check important info. Chat history is never stored.

Job Description

  1. Conducts audits in the operational areas to include:
    • Monthly audits to monitor controls and performance.
    • Document and review findings with operational staff and management.
    • Track audit results and spot error trends to identify training needs and process improvements.
  2. Perform other functions to include:
    • Identify specific case/scenarios beneficial for information sharing and lead discussions of case/scenario in unit meetings.
    • Conducts audit for new hires and operational staff learning new functions, transitioning to new system changes or processing procedures.
    • Develop reference and training documentation and conduct training for our operational staff.
    • Track and perform post-training audit to ensure training effectiveness.
    • Respond to simple audit findings or inquiries from internal departments. Working with management, review findings, conduct root cause analysis, and execute follow-up action.
    • Triage simple questions and issues raised by operational staff. Perform root cause analysis of processing issues. Collaborate with management and subject matter experts to resolve production issues.
  3. Support business or system changes.
    • Review and contribute to business requirements or system changes. Represent our operational area in meetings to discuss requirements.
    • Participate on project testing activities to include development of test cases, submitting test claims, validating and approving test results. Support project rollout to the operational areas.
    • Review documents and attend meetings relating to business requirements or system changes
  4. Regularly participate in process and operational improvement activities. Complete or participate in corporate training, compliance certification or initiatives as directed by management
  5. Performs all other miscellaneous responsibilities and duties as assigned or directed.
 
Qualifications
  1. Associate's degree and two year of related work experience; or an equivalent combination of education and related work experience.
  2. Strong verbal and written communications skills.
  3. Working knowledge of medical terminology, health industry coding systems (procedure and diagnosis codes, etc.), CMS1500 or UB04 claim forms.
  4. Ability to develop reference and training documentation.
  5. Ability to coach/train staff and track and evaluate effectiveness of training.
  6. Keyboard and typing skills with low error rate.
  7. Intermediate knowledge of Microsoft Office applications, including but not limited to Word, Excel, Outlook, and PowerPoint.
HMSA

About HMSA

The Hawaii Medical Service Association (HMSA), an independent licensee of the Blue Cross and Blue Shield Association, is a reliable name in Hawaii health care. Established in 1938, we are the largest and most experienced provider of health care coverage in the state. Over half of Hawaii’s population have chosen HMSA for their health care coverage.

We are dedicated to providing quality, affordable health plans; employee benefit services; and worksite wellness programs. HMSA also offers a variety of programs, services and support to help improve the health and well-being of our members and community.

Industry
Finance & Insurance
Company Size
1,001-5,000 employees
Headquarters
Honolulu, Hawaii
Year Founded
1938
Website
hmsa.com
Social Media