Claims Processor I

[]{#docs-internal-guid-de84fbf2-7fff-e0d1-063b-2e45b95319a3} Apply Here: ## {#section dir="ltr"} 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. [ ]{#docs-internal-guid-de84fbf2-7fff-e0d1-063b-2e45b95319a3} 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. [ ]{#docs-internal-guid-de84fbf2-7fff-e0d1-063b-2e45b95319a3} 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 [ ]{#docs-internal-guid-de84fbf2-7fff-e0d1-063b-2e45b95319a3} 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 [ ]{#docs-internal-guid-de84fbf2-7fff-e0d1-063b-2e45b95319a3} 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 [ ]{#docs-internal-guid-de84fbf2-7fff-e0d1-063b-2e45b95319a3} 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 ::: {dir="ltr" role="presentation"} []{#docs-internal-guid-cc7e5a06-7fff-7446-263a-7f2b80882956} 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 :::