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About Pacific Administrators
Pacific Administrators (PAI) was founded in 2001 with a mission to provide exceptional Third-Party Administration services to Multi-Employer (Taft-Hartley) Employee Benefit Plan Trust Funds. PAI has been awarded one of Hawaii Business Magazine's Best Places to Work for 2026 and is Hawaiis Largest Locally Owned and Operated Third-Party Administrator.
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About the Role
The Claims Processor I will work under the Claims Department Supervisor to process all medical, hospital, vision, chiropractic and ancillary claims, which includes coordination of benefit and third-party liability claims in accordance with department policies and procedures.
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Responsibilities:
- Process Medical claims
- Process Hospital and Ancillary Claims
- Process Vision and Chiropractic Claims
- Send referrals to Managed Care Department
- Send claims to contract negotiator for individual negotiations
- Correct and submit error tickets
- Process Claim Adjustments
- Assist Customer Service Department with customer inquiries
- Assist Department Lead and/or Supervisor with other departmental or Health and Welfare duties
- Be able to maintain error rate and production quotas
- Occasional carrying, loading and transporting of supplies
- Perform other duties as assigned
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Requirements:
- Minimum of (2) year work experience or equivalent (combination of education and work)
- Type 45 WPM
- 10-key by Touch
- Computer literate in Word and Excel and other Microsoft applications
- Good organization skills and able to handle multi tasks
- Good analytical skills
- Self-starter and quick learner
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Nice to Haves:
- Knowledge of ICD-9, ICD-10, CPT, HCPCS, FORM 1500, and UB04 forms, Medical and Revenue Coding, and Medical Terminology is a plus
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Working Conditions:
- PAI offices are indoors and air-conditioned while conditions may vary at client locations
- Monday to Friday, 8:00 - 4:00 PM or 8:30 AM - 4:30 PM, with a 1-hour unpaid lunch
- The duties assigned will have situations that will require extra time
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Benefits:
- Medical, Dental, Vision Insurance and Prescription Drug Coverage - 100% of Employee's Medical Insurance premiums are paid for by the company for a single participant (or 50% of Employee + Dependents total premiums)
- Paid Vacation, Sick and Personal Time
- 401(k) Plan with Company Match
- Commuter Benefit - 50% of the cost of monthly Bus pass or 50% of parking is paid for by the company
- Monthly Movie Days
- Flexible Spending Account
- Group Life Insurance
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