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Claims Liaison Specialist

HMSA, Honolulu, HI, United States

Duration: Full Time


  1. Function as a central communication point between claims processing teams and internal/external partners regarding claim status, issues and resolutions.

  2. Investigate and resolve escalated claims and trends, including denied or delayed claims, by coordinating with relevant departments to implement short- and long-term solutions and process improvements.

  3. Manage open claims issues to ensure timely resolution in compliance with internal SLAs and regulatory standards.
    Collaborate with internal teams to conduct training sessions and measure effectiveness of training.

  4. Provide support for audits, appeals, and compliance-related activities

  5. Participate in system updates, and cross-functional meetings to stay current on claims processing procedures and benefit plan designs.

  6. Document all interactions, updates, and outcomes clearly in case management or claims systems.

  7. Performs all other miscellaneous responsibilities and duties as assigned or directed



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