Research Coordinator

Hawaii Medical Service Association • Honolulu, HI

1d

About The Position

The Research Coordinator coordinates case resolution with internal business areas and responds to provider inquiries about claims, benefits, medium-complexity medical or payment policy issues, and provider appeals. The role researches and resolves medium-complexity issues, addresses root problems to support compliance with contract terms and servicing goals, and communicates directly with providers and office staff about case information and resolutions.

The coordinator represents Provider Services on cross-department workgroups, communicates provider impacts and perspectives to internal business areas, and coordinates system issue resolution and communications about core system changes and issues. The role develops business requirements and test cases to validate system changes and upgrades.

The position also develops provider education and training materials, coordinates content and provider communications with other business areas, maintains the Provider Servicing staff training program, and trains and mentors employees. It develops and maintains success measurement activities, department workflows and procedures, and participates in process improvements. Other miscellaneous responsibilities may be assigned or directed.

Requirements

• Bachelor's degree and two years of related work experience, or an equivalent combination of education and related work experience.
• Effective verbal and written communication skills.
• Basic working knowledge of Microsoft Office applications, including Word and Outlook/email.

Responsibilities

• Coordinate case resolution with internal business areas to respond to provider inquiries about claims, benefits, medium-complexity medical or payment policy issues, and provider appeals.
• Research and resolve medium-complexity issues and address root problems to support compliance with contract terms and servicing goals.
• Communicate directly with providers and office staff to gather case information and explain issue resolutions.
• Represent Provider Services on cross-department workgroups; identify impacts to providers and communicate the provider perspective to internal business areas.
• Coordinate system issue resolution and facilitate internal and external communications about core system changes and issues.
• Develop business requirements and test cases to validate that system changes and upgrades meet business requirements.
• Develop provider education and training materials, including workshop presentations and written materials.
• Coordinate educational content development with other business areas and obtain business approval.
• Coordinate and develop provider communications to ensure information is available to providers accurately and on time.
• Coordinate and maintain the Provider Servicing staff training program; train new employees and provide ongoing guidance and mentoring to research and field staff.
• Develop and maintain success measurement activities that support department goals.
• Develop, implement, and maintain department workflows and procedures.
• Identify and participate in process improvements to increase operational efficiency.
• Perform other miscellaneous responsibilities and duties as assigned or directed.

What This Job Offers

• Job Type: Full-time