Top 71 Claims specialist Jobs in Kapolei Hi

Healthcare Insurance Payor Contracts & Credentialing Specialist
Pharmacare —Honolulu, HI
- $30 - $35 an hour
- Full-time
- Background check
- Microsoft Outlook
- Pass drug screening
- Health insurance
- Dental insurance
Quick Apply
11d
Claims Specialist Lead
Progressive —Honolulu, HI
- $88,000 - $115,000 a year
- Hybrid work
- Customer service
- 5 years
- Office
- Health savings account
- Disability insurance
HR Benefits Specialist
HiEmployment —Schofield Barracks, HI
- $30 an hour
- Full-time
- HIPAA
- Mid-level
- Office
- Paid holidays
- Health insurance
Quick Apply
9d
Medical Billing Collections Specialist
Excel Health —Honolulu, HI
- From $24 an hour
- Full-time
- Background check
- Mid-level
- Organizational skills
- Health insurance
- Dental insurance
Quick Apply
Safety Professional
Grace Pacific LLC —Kapolei, HI
- $65,000 - $94,000 a year
- Weekends as needed
- Microsoft Outlook
- Addiction Medicine
- Construction site
Quick Apply
Insurance Specialist 3 - Long Term Care Biller (REMOTE)
CorroHealth Inc —Honolulu, HI
- 8 hour shift
- Remote
- 5 years
- Basic math
- Research
- Paid parental leave
- Paid holidays
Quick Apply
HUMAN RESOURCES SPECIALIST VI (EMPLOYEE CLAIMS) - OAHU
State of Hawaii —O'ahu, HI
- $6,914 - $8,414 a month
- Office
- 3 years
- Bachelor's degree
- Mileage reimbursement
- Commuter assistance
HUMAN RESOURCES SPECIALIST III, IV AND V - WORKERS' COMPENSATION - OAHU
State of Hawaii —O'ahu, HI
- $5,107 - $7,568 a month
- Urgently hiring
- Bachelor's degree
- US work authorization
- Military encouraged
- Mileage reimbursement
- Commuter assistance
Claims Specialist - Property
ISLAND INSURANCE —Honolulu, HI
- $70,000 - $90,000 a year
- Mid-level
- High school diploma or GED
Quick Apply
Senior Claims Specialist - Casualty
TRADEWIND GROUP INC —Honolulu, HI
- $90,000 - $105,000 a year
- Full-time
- 5 years
- High school diploma or GED
- Driver's License
Quick Apply
DSD Inventory Specialist
Mondelēz International —Honolulu, HI
- $56,200 - $77,275 a year
- Full-time
- Mid-level
- Continuous improvement
- Warehouse
- Paid holidays
- Disability insurance
ID Card Specialist; Honolulu, HI
Magellan Health —Honolulu, HI
- Full-time
- Microsoft Excel
- Mid-level
- High school diploma or GED
11d
Claims Reimbursement Specialist - Business Office, CareResource Hawaii (Full Time, 40, Day)
CareResource Hawaii —Honolulu, HI
- Full-time
- Microsoft Outlook
- Computer literacy
- English
Benefits Specialist
Island Palm Communities —Schofield Barracks, HI
- $62,400 a year
- Full-time
- HIPAA
- Mid-level
- Office
- Wellness program
- AD&D insurance
Quick Apply
10d
Administrative Travel Specialist
PEOPLE TECHNOLOGY AND PROCESSES LLC —Pearl Harbor, HI
- $25 - $35 an hour
- Microsoft Excel
- Mid-level
- Office
Quick Apply
SECURITY SPECIALIST
US Immediate Office of the Chief of Naval Operations —Camp H M Smith, HI
- $52,680 - $83,774 a year
- Overtime
- Customer service
- Pass drug screening
- Research
- Loan repayment program
3d
Billing Support Specialist
Waianae Coast Comprehensive Health Center —Waianae, HI
- $19.85 - $21.85 an hour
- Full-time
- Mid-level
- Administrative experience
- High school diploma or GED
Quick Apply
12d
Managed Care Contracts Specialist (Full-Time, 40 Hours, Day Shift)
The Queens Health Systems —Honolulu, HI
- $65,722 - $80,510 a year
- Full-time
- Word processing
- Mid-level
- Office
IT Specialist (NETWORK)
US Immediate Office of the Chief of Naval Operations —Camp H M Smith, HI
- $101,091 - $131,422 a year
- Overtime
- Hybrid work
- Pass drug screening
- Mid-level
- Travel
- Loan repayment program
Contract Specialist
US Executive Office for U.S. Attorneys and the Office of the U.S. Attorneys —Honolulu, HI
- $64,438 - $83,774 a year
- Part-time
- Background check
- Writing skills
- Pass drug screening
- Paid holidays
- Life insurance
6d

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claims specialist jobs near kapolei hi

Healthcare Insurance Payor Contracts & Credentialing Specialist

Pharmacare -
Honolulu, HI

Quick Apply

Job Details

Full-time
$30 - $35 an hour
11 days ago

Benefits

Health insurance
Dental insurance
401(k)
Paid time off
Vision insurance

Qualifications

Teamwork
Microsoft Outlook
Interpersonal skills
Certified Provider Credentialing Specialist
Data management
Attention to detail
Microsoft Teams
Technical Proficiency

Full Job Description

About Pharmacare:

Care Done Right For over 90 years, Pharmacare Hawaii has been providing care to its patients with the same Aloha Spirit as they did for generations. Today this third generation locally owned and operated pharmacy employs nearly 200 employees over its locations on Oahu, Maui, Kauai and Hilo. Be part of the team that is committed to helping improve the health of our community. 2025 Hawaii Business Magazine Top 250 Company

Job Summary:

The Healthcare Insurance Payor Contracts & Credentialing Specialist is responsible for overseeing payor contract data, streamlining provider enrollment, and maintaining regulatory compliance across all health plans. This position acts as a critical link between contracting, credentialing, billing, and operational teams to ensure seamless revenue cycle management, prevent reimbursement disruptions, and ensure provider directory accuracy.

Key Responsibilities:

Provider Enrollment & Credentialing Operations

Execute end-to-end provider enrollment, primary source verification, and re-credentialing with commercial, Medicare, Medicaid, and managed care payors.
Maintain accurate records in provider enrollment databases (e.g., CAQH, NPPES, PECOS) and state licensing boards.
Prepare and support delegated credentialing audits, payor directory reviews, and roster submissions.

Contract Analysis & Data Integrity

Maintain internal contract management systems, fee schedules, payor lines of business (LOB), and fee schedule effective dates.
Audit and reconcile payor directory listings regularly to ensure strict compliance with contractual and regulatory standards.
Track contract amendments, rate changes, and expiration dates to ensure timely renewals and updates.

Revenue Cycle & Issue Resolution

Investigate and resolve credentialing- or contract-related claim denials and billing holds in collaboration with billing and receivables teams.
Identify root causes of payor enrollment bottlenecks and implement workflow improvements to reduce time-to-in-network status.
Serve as a subject matter expert and key liaison for payor representatives regarding enrollment status, contracting updates, and demographic changes.

Schedule: Monday through Friday, 8:30 am - 5:00 pm

This position is in-person at our office in Honolulu.

Minimum Qualifications:

Experience: 2+ years of hands-on experience in healthcare payor contracting, provider enrollment, or credentialing.
Systems Proficiency: Direct experience with CAQH ProView, PECOS, NPPES, and electronic credentialing management software.
Knowledgeable of MS Office applications including Word, Excel, Outlook, Teams, etc.
MUST be able to pass a background check and drug screen

Preferred Qualifications

Education: Associate or Bachelor’s degree in Healthcare Administration, Business, or related field preferred (equivalent practical experience considered).
Certifications: Certified Professional Credentialing Specialist (CPCS) or Certified Provider Credentialing Specialist credential a strong plus.
Technical Tools: Familiarity with AI-assisted credentialing tools, automated license-monitoring platforms, and practice management/EHR platforms.
Core Competencies: Exceptional attention to detail, strong data management skills, and clear professional communication.
Good verbal and written communication skills

Job Type: Full-time

Pay: $30.00 - $35.00 per hour

Benefits:

401(k)
Dental insurance
Health insurance
Paid time off
Vision insurance

Application Question(s):

Are you able to pass a background check and drug screen?

Experience:

hands-on healthcare payor contracting: 2 years (Required)
hands-on provider enrollment: 2 years (Required)
hands-on credentialing: 2 years (Required)
electronic credentialing management software: 2 years (Required)

Ability to Commute:

Honolulu, HI 96819 (Required)

Work Location: In person

Quick Apply

Refine Your Search

claims specialist jobs in kapolei hi

Healthcare Insurance Payor Contracts & Credentialing Specialist

Claims Specialist Lead

HR Benefits Specialist

Medical Billing Collections Specialist

Safety Professional

Insurance Specialist 3 - Long Term Care Biller (REMOTE)

HUMAN RESOURCES SPECIALIST VI (EMPLOYEE CLAIMS) - OAHU

HUMAN RESOURCES SPECIALIST III, IV AND V - WORKERS' COMPENSATION - OAHU

Claims Specialist - Property

Senior Claims Specialist - Casualty

DSD Inventory Specialist

ID Card Specialist; Honolulu, HI

Claims Reimbursement Specialist - Business Office, CareResource Hawaii (Full Time, 40, Day)

Benefits Specialist

Administrative Travel Specialist

SECURITY SPECIALIST

Billing Support Specialist

Managed Care Contracts Specialist (Full-Time, 40 Hours, Day Shift)

IT Specialist (NETWORK)

Contract Specialist

I want to receive the latest job alert for claims specialist in kapolei hi

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