69 Results for

Claims Processor Jobs in Hawaii

Jobs

Honolulu, HI21 days ago

$60,000–$90,000 Per Year

The Claims Examiner will oversee claim investigations, evaluate coverage and damages, coordinate with Third-Party Administrators (TPAs), field adjusters, consultants, and vendors, and negotiate claim settlements in accordance with company guidelines and regulatory requirements. This role is responsible for managing complex Property and Casualty insurance claims including structural property damage, auto liability, casualty, and workers’ compensation-related claims.

kAPOLEI, HI11 days ago

$70,000–$95,000

This role requires frequent interaction with clients, claimants, medical providers, attorneys, vendors, nurse case managers, vocational case managers, and internal staff. At the direction of the Claims Supervisor and/or Claims Manager, the Claims Adjuster/Examiner II / III manages all aspects of workers’ compensation indemnity, medical-only, future medical, and litigated claims from inception through resolution, within established authority and company/client guidelines.

New!

Kapolei, HI4 days ago

$85,000–$90,000

This role handles highly complex claims and plays a critical part in ensuring compliance with state regulations, timely investigations, accurate reserving, and effective claim resolution. The position requires strong analytical judgment, excellent communication skills, and consistent collaboration with clients, claimants, vendors, legal counsel, and internal teams.

New!

Honolulu, HI2 days ago

Full-time

The ideal candidate will excel at collaborating with third-party adjusters, vendors, and industry experts to ensure claims are handled efficiently and accurately while delivering exceptional service to agents and claimants. This role involves overseeing and managing complex property and casualty claims, including those related to building and structural damage, auto, and workers’ compensation.

New!

Kapolei, HI4 days ago

$85,000–$95,000

This role requires frequent interaction with clients, claimants, medical providers, attorneys, vendors, nurse case managers, vocational case managers, and internal staff. At the direction of the Claims Supervisor and/or Claims Manager, the Claims Examiner II / III manages all aspects of workers’ compensation indemnity, medical-only, future medical, and litigated claims from inception through resolution, within established authority and company/client guidelines.

Honolulu, HI30+ days ago

Remote

Full-time

Proficient with claim and coding tools and resources, Clinical Decision Support Tool, Current Procedural Terminology, Health Care Financing Administration Common Procedure Coding System, and American Dental coding. Provides clinical and coding-related information to medical director, providers, peer reviewers, Claims Administration, Program Integrity, Quality Management, and/or the Claims Subcontractor as needed.

Honolulu, Hawaii8 days ago

$22–$26 Per Hour

Honolulu, HI30+ days ago

Remote

Full-time

Under limited supervision, manages and performs claims department activities related to recoupments and collections, including validation of recoupment setup, conducting collections calls with providers, establishing payment arrangements, tracking and trending outstanding recoupments, establishing payment arrangements, and coordinating collections activities with other departments. Proficient with claim and coding tools such as Supercoder, Clinical Decision Support Tool, Current Procedural Terminology, Health Care Financing Administration Common Procedure Coding System, and American Dental coding.

Honolulu, HI14 days ago

$59,059.65–$82,000 Per Year

With the opportunity to initially earn up to 20 days annually plus parental leave, paid holidays, celebration day, life leave (40 hours/year), bereavement leave, and community service/education support days, there will be plenty of time for you! Additional Details: Employees must successfully complete all required training, including applicable licensing exam(s), Motor Vehicle Record (MVR) checks, and background checks required of various state(s).

Honolulu, HI30+ days ago

$112,032–$179,220

This critical role manages construction claims and advises HART's leadership on their nature and status while ensuring timely resolution of disputes, including bid protests arising from procurement processes. Utilize knowledge of Hawaii's Public Procurement Code to analyze and draft responses to bid protests and assist in preparing briefs for hearings at the Department of Commerce and Consumer Affairs.

Honolulu, HI30+ days ago

Remote

Full-time

The Supervisor, Claims Administration interacts and collaborates frequently with beneficiaries, Veterans, providers, sub-contractors, the Government, and internal business partners to resolve issues, respond to inquiries, and improve processes. Organizational Skills: Ability to organize people or tasks, adjusts to priorities, learns systems within time constraints and with available resources; detail-oriented.

Maui County, HI28 days ago

Distinguishing Characteristics: This class differs from the Insurance and Claims Assistant I class in that it is responsible for performing the full range and variety of work involving the review and evaluation of underwriting data, insurance proposals and contracts; preparation of comparative cost and benefit analysis; identification and examination of potential sources of liability and loss; and processing and auditing of claims; whereas the Insurance and Claims Assistant I is responsible performing moderately difficult work involving compilation, review and analysis of underwriting data to identify and monitor risk exposures, preparation of insurance documents and specifications, and the processing of claims in support of the County's risk management program. Performs specialized clerical and administrative support services relating to underwriting and analyzing insurance policies and contracts, reviewing and monitoring risk exposure and loss control activities, establishing and maintaining document/record control systems and processing insurance claims; formulating insurance bid specifications; and performing other related duties as required.

Honolulu, HI30+ days ago

Remote

Full-time

Proficient with claim and coding tools such as Supercoder, Clinical Decision Support Tool, Current Procedural Terminology, Health Care Financing Administration Common Procedure Coding System, and American Dental coding. This role will serve as a SME and will collaborate with Claims leadership, Training, the Claims Content Specialist, and internal business partners to ensure procedures and training materials are accurate and complete.

Honolulu, HI30+ days ago

Remote

Full-time

Independent Thinking / Self-Initiative: Critical thinkers with ability to focus on things which matter most to achieving outcomes; Commitment to task to produce outcomes without direction and to find necessary resources. Organizational Skills: Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources; Detail-oriented.

HONOLULU, HI30+ days ago

$60,000–$75,000 Per Year

Provide clear, professional communication to clients and injured workers—setting expectations early and escalating complex exposures to senior adjusters appropriately. In this role you’ll manage a high-volume portfolio of medical-only claims from first report through closure — ensuring regulatory compliance, accurate reserving, timely medical management, and a professional experience for both employers and injured workers.

HONOLULU, HI30 days ago

$76,000–$98,000 Per Year

You'll be expected to manage a caseload of 90–100 active files, maintain a 1:1 or better new-to-closure ratio, and keep every diary current — all while staying ahead of statutory deadlines and delivering a strong client experience. Actively manage medical treatment plans using evidence-based guidelines (ODG), initiate IMEs when appropriate, and coordinate return-to-work and vocational strategies to reduce indemnity duration.

Makawao, HI30+ days ago

Full-time

How We Can Help You Succeed:At MileHigh Adjusters Houston, we offer comprehensive training programs tailored to equip you with the essential skills and knowledge needed to excel in the field of claims adjusting. Visit our website at www.milehighadjustershouston.com to explore our offerings and view our 375+ Five-Star Google Reviews.

Kailua Kona, HI30+ days ago

Full-time

Pearl City, HI30+ days ago

Full-time

Mililani, HI30+ days ago

Full-time

Lahaina, HI30+ days ago

Full-time

Kahului, HI30+ days ago

Full-time

Kapaa, HI30+ days ago

Full-time

Aiea, HI30+ days ago

Full-time

Lihue, HI30+ days ago

Full-time

Honolulu, HI30+ days ago

Full-time

Hilo, HI30+ days ago

Full-time

Haiku, HI30+ days ago

Full-time

Kaneohe, HI30+ days ago

Full-time

Kapolei, HI30+ days ago

Full-time

Pahoa, HI30+ days ago

Full-time

Kihei, HI30+ days ago

Full-time

Ewa Beach, HI30+ days ago

Full-time

Kamuela, HI30+ days ago

Full-time

Kailua, HI30+ days ago

Full-time

Honolulu, HI9 days ago

$20–$26 Per Hour

The Pharmacy Technician will support the oversight of Medicare operations delegated to our Pharmacy Benefit Manager (PBM), proactive Medicare rejected claim outreach, the processing and/or review of Prior Authorization/Coverage Determination, appeal and grievance requests, participate in the Medicare annual plan build implementation and testing, manage the Pharmacy help desk line, assist Customer Service on drug-related concerns/issues for the AlohaCare QUEST and Advantage Plus (ACAP) Plans, and provide administrative support for formulary management and compliance related functions of the AlohaCare Pharmacy Department. Adhere to turnaround times (TAT) for PAs/CDs as required by the Centers for Medicare & Medicaid Services (CMS), Med-QUEST (Hawaii Medicaid), and National Committee for Quality Assurance (NCQA).

Honolulu, Hawaii30+ days ago

$24.10–$30.66 Per Hour

From Australia to California, and of course, Hawaii, Team Servco is a collective of over 2,000 like-minded individuals guided by our four Core Values of Respect, Service, Teamwork, and Innovation. This role supports dealers with claims procedures and serves as a liaison between dealers and our manufacturers to ensure accurate, timely submission of required documentation and evidence.

New!

Honolulu, HI3 days ago

Coordinates benefits with other insurance carriers and processes simple claim adjudication, as well supports Claims Processing with data entry and claims up to Level 2. Responds to all inquiries and resolves issues in an efficient and timely manner, as established by Team Goals and Objectives. Under the supervision of the Customer Service Manager, responds to customer inquires and resolves customer issues, and provides information about eligibility, benefits, and claims information during incoming/outbound calls or walk-ins and within written or electronic correspondence.

US, Kauai, HI8 days ago

$28.50–$34.21 Per Hour

Principal Duties and Responsibilities: o Based out of your home, travel to distributed and utility-scale solar and battery storage facilities in local region to perform preventative & corrective maintenance o Perform other technical and administrative duties associated with operating and maintaining a power facility o Coordinate and manage contractors engaged to support maintenance activities o Provide limited support for commissioning activities o Lead/support warranty claims processes with vendors as needed. o Perform work independently and in team environments Desired Skills, Expertise and Competencies: o Proven experience with a variety of electrical equipment and knowledge of basic IT and remote communications equipment o Experience with Battery Energy Storage systems (BESS), a plus.

Honolulu, HI30+ days ago

Prepares customer statements, bills and invoices, reconciles expenses to the general ledger, takes care of basic client inquiries, and performs other clerical tasks related to maintaining the accounts receivable records for the organization. Ensures regular payor (provider representatives) meetings are conducted to ensure trends are addressed and individual accounts are resolved.

Honolulu, Hawaii10 days ago

$19.42–$24.36 Per Hour

From Australia to California, and of course, Hawaii, Team Servco is a collective of over 2,000 like-minded individuals guided by our four Core Values of Respect, Service, Teamwork, and Innovation. This position will play a key role in processing warranty claims and provide our dealerships assistance with dealer claims processing.

New!

Hilo, HI2 days ago

Performs a variety of specialized administrative clerical functions in connection with the processing of contracts for personal services, professional services, procurement of othergoods and services, lease agreements, memorandum of understandings (MOU), and memorandum of agreements (MOA); and performs other related duties as required. Other Leaves: You may be eligible for other leaves, including Family Leave, Funeral Leave, Leave Sharing, Military Leave, Donor Leave, Victims Protection Leave, as well as leave for Parent-Teacher Conferences, Disaster Relief, Blood Bank Donations, and Jury Duty.

New!

Hilo, HI2 days ago

$50,652–$61,596 Per Year

Independently performs a wide range of technical human resources work in support of a departmental human resources program or in support of one or more functional areasin the central human resources department requiring the interpretation and application of civil service laws, human resources policies and procedures, and pertinent provisions of collective bargaining agreements; and performs other related duties as required. Other Leaves: You may be eligible for other leaves, including Family Leave, Funeral Leave, Leave Sharing, Military Leave, Donor Leave, Victims Protection Leave, as well as leave for Parent-Teacher Conferences, Disaster Relief, Blood Bank Donations, and Jury Duty.

Honolulu, HI30+ days ago

Remote

Full-time

Technical Skills: Knowledge of technology impacts on business strategic direction enabling definition and integration of technical plans supporting the enterprise business functions; knowledge and expertise in project/program management methodologies and tools to include Agile; experience with product/solution/system lifecycles; expert knowledge in one or more of: system servers and data network; traditional telephony principals and support; Microsoft enterprise software, server principals and support; HP enterprise products and services: data communication and network architectures, design, and support; installation, maintenance and support of large scale application systems; healthcare industry experience, to include medical management and provider data/solutions: proficient with Microsoft Project, Project Server, Visio, and SharePoint Services. • 7+ years of related and progressive experience combining various elements of technical delivery or support, solutions implementation, process automation, project management, and team leadership .

Honolulu, HI30+ days ago

Remote

Full-time

The Director ensures the delivery of exceptional service to providers and government stakeholders by directing cross-functional programs that enhance provider satisfaction, strengthen network engagement, and uphold contractual and regulatory compliance. Coaching / Training / Mentoring: Actively develops the skills and capabilities of direct reports and extended team members through constructive feedback, mentoring relationships, and structured development opportunities aligned with business outcomes.

Honolulu, HI30+ days ago

Remote

Full-time

Technical Skills: The ability to solve problems independently while working in a fast paced, energetic environment; strong communication skills, (oral and writing skills); a proven ability as a facilitator/instructor; self-motivated, able to work in a team and independently. Independent Thinking / Self-Initiative: Critical thinkers with ability to focus on things which matter most to achieving outcomes; commitment to task to produce outcomes without direction and to find necessary resources.

Lihue, HI10 days ago

As an Insurance Customer Service Representative, you will be a key point of contact for our clients, providing timely and accurate information while ensuring a positive customer experience. This role involves addressing inquiries, resolving issues, and offering support on a variety of insurance-related matters.

US, Waikoloa, HI9 days ago

$35–$42.08 Per Hour

A day in the life of Field Operations Solar & BESS Technician II will include, but is not limited to: Listen, collaborate, and apply advanced troubleshooting ability, take direct instruction from the Senior Technicians, and support the team at solar+battery facilities at Waikoloa site (Big Island) and other sites currently under construction in performing preventive & corrective maintenance and supporting ongoing construction activities. Ensure timely, complete, and high-quality documentation related to O&M activities, including but not limited to service tickets, maintenance reports, switching orders, and safety-related documentation such as JHAs/JSAs, Safe Work Permits, LOTO, Energized Electrical Work Permits, and excavation permits, etc.).

Aiea, HI30+ days ago

This position involves checking in patients, verifying insurances, making confirmations calls, providing exceptional customer service, managing patient interactions, and supporting the overall operational efficiency of our practice. Our passionate team is dedicated to transforming smiles and enhancing lives, and we're on the lookout for a talented Dental Treatment Coordinator / Front Office Receptionist to join our family.

Honolulu, HI30+ days ago

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Claims Processor Jobs in Hawaii

Claims Examiner - Property and Casualty Insurance - Base Salary to 90k/year - Honolulu, HI AllSearch Professional Staffing

Workers Compensation Claims Examiner II/III - Hybrid TEEMA

Workers Compensation Claims Examiner II/III TEEMA Group

Claims Examiner - HYBRID DB Insurance Co., Ltd.

Workers Compensation Claims Examiner III TeemaGroup

Claims Reviewer TriWest Healthcare Alliance

Surveillance / Claims Investigator - Part-Time Allied Universal

Claims Recoup & Collect Anlyst TriWest Healthcare Alliance

Claims Appraiser - Auto Estimatics State Farm

Deputy Director of Construction Claims Honolulu Authority for Rapid Transportation

Supervisor, Claims Admin TriWest Healthcare Alliance

Insurance and Claims Assistant II (SR-14) County Of Maui

Sr Claims Reviewer TriWest Healthcare Alliance

Claims Escalation Rep TriWest Healthcare Alliance

Associate Workers' Compensation Claims Adjuster ProService Hawaii

Workers' Compensation Claims Adjuster ProService Hawaii

Independent Insurance Claims Adjuster in Makawao, Hawaii MileHigh Adjusters Houston Inc

Independent Insurance Claims Adjuster in Kailua Kona, Hawaii MileHigh Adjusters Houston Inc

Independent Insurance Claims Adjuster in Pearl City, Hawaii MileHigh Adjusters Houston Inc

Independent Insurance Claims Adjuster in Mililani, Hawaii MileHigh Adjusters Houston Inc

Independent Insurance Claims Adjuster in Lahaina, Hawaii MileHigh Adjusters Houston Inc

Independent Insurance Claims Adjuster in Kahului, Hawaii MileHigh Adjusters Houston Inc

Independent Insurance Claims Adjuster in Kapaa, Hawaii MileHigh Adjusters Houston Inc

Independent Insurance Claims Adjuster in Aiea, Hawaii MileHigh Adjusters Houston Inc

Independent Insurance Claims Adjuster in Lihue, Hawaii MileHigh Adjusters Houston Inc

Independent Insurance Claims Adjuster in Honolulu, Hawaii MileHigh Adjusters Houston Inc

Independent Insurance Claims Adjuster in Hilo, Hawaii MileHigh Adjusters Houston Inc

Independent Insurance Claims Adjuster in Haiku, Hawaii MileHigh Adjusters Houston Inc

Independent Insurance Claims Adjuster in Kaneohe, Hawaii MileHigh Adjusters Houston Inc

Independent Insurance Claims Adjuster in Kapolei, Hawaii MileHigh Adjusters Houston Inc

Independent Insurance Claims Adjuster in Pahoa, Hawaii MileHigh Adjusters Houston Inc

Independent Insurance Claims Adjuster in Kihei, Hawaii MileHigh Adjusters Houston Inc

Independent Insurance Claims Adjuster in Ewa Beach, Hawaii MileHigh Adjusters Houston Inc

Independent Insurance Claims Adjuster in Kamuela, Hawaii MileHigh Adjusters Houston Inc

Independent Insurance Claims Adjuster in Kailua, Hawaii MileHigh Adjusters Houston Inc

Pharmacy Technician AlohaCare

Warranty Specialist Servco Pacific Job Distro

Customer Service Representative HAWAII DENTAL SERVICE

Solar & BESS Technician I AES Corporation

Revenue Cycle Coordinator Surgicare of Hawaii, Inc.

Warranty Associate Servco Pacific Job Distro

Contracts Clerk - SR-12 Hawaii County, HI

Human Resources Technician I - SR-15 Hawaii County, HI

IT Delivery Lead TriWest Healthcare Alliance

Director, Provider Experience TriWest Healthcare Alliance

Provider Relations Rep TriWest Healthcare Alliance

Customer Service Representative Yukimura and Associates - Allstate Insurance

Solar & BESS Technician II AES Corporation

Front Desk Dental Coordinator Rising Tide Dental

Dental Office Receptionist Rising Tide Dental

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