- Sustains mastery of encounter system processes within HMSA and external partners, for multiple lines of business.
- Monitors trends in data exchange with external entities and recommends adjustments as needed.
- Researches highly nuanced claim-member-provider scenarios to determine root cause of data submission errors.
- Leads collaboration with internal staff to optimize encounter submission processes.
- Leads the planning, design, implementation, and testing of projects to increase the scope or efficacy of encounters submission.
- Prioritizes project deliverables to ensure business needs are met.
- Serves as a resource for colleagues with less experience.
- Provides data to support financial reporting.
- Monitors government/vendor requirements changes. Determines and communicates impact, recommends adjustments as needed.
- Bachelor's degree and four years of related experience; or an equivalent combination of education and experience.
- Working knowledge of claims, health plan financial data, and health industry structure.
- Working knowledge of Medicare Advantage, Medicaid, and/or ACA revenue cycles for payers.
- Intermediate working knowledge of Microsoft Office applications, including but not limited to Word, Excel, Outlook, and PowerPoint.
- Conceptual knowledge of SQL, SAS, or MicroStrategy.
Skills Required
- Bachelor's degree and four years of related experience
- Working knowledge of claims, health plan financial data, and health industry structure
- Working knowledge of Medicare Advantage, Medicaid, and/or ACA revenue cycles for payers
- Intermediate working knowledge of Microsoft Office applications
- Conceptual knowledge of SQL, SAS, or MicroStrategy
HMSA Compensation & Benefits Highlights
The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about HMSA and has not been reviewed or approved by HMSA.
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Healthcare Strength — Medical and dental coverage are described as solid, with preventive services and select zero‑cost features adding value in recent plan years. Employer-sponsored plans can have affordable premiums in certain groups and broad access options.
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Retirement Support — A 401(k) with company match and potential discretionary contributions forms a strong component of total rewards. Retirement support complements the core medical and dental package.
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Leave & Time Off Breadth — Paid holidays and PTO that increases with tenure provide meaningful time‑off flexibility. Time‑away benefits scale with service length.
HMSA Insights
What We Do
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.
