Claims Liaison Specialist

Job Summary

Hybrid Work Environment - Must reside on Oahu
Pay Range: $47,500 - $88,000
Note: Individuals typically begin between the minimum to middle of the pay range

Duties And Responsibilities

• Function as a central communication point between claims processing teams and internal/external partners regarding claim status, issues and resolutions.
• Investigate and resolve escalated claims and trends, including denied or delayed claims, by coordinating with relevant departments to implement short- and long-term solutions and process improvements.
• Manage open claims issues to ensure timely resolution in compliance with internal SLAs and regulatory standards.
• Collaborate with internal teams to conduct training sessions and measure effectiveness of training.
• Provide support for audits, appeals, and compliance-related activities.
• Participate in system updates, and cross-functional meetings to stay current on claims processing procedures and benefit plan designs.
• Document all interactions, updates, and outcomes clearly in case management or claims systems.
• Perform all other miscellaneous responsibilities and duties as assigned or directed.