Claims Auditor - Health & Welfare (Hybrid)
About The Position
As a Health and Welfare Claims Auditor, the main focus will be to review the work completed by the Health and Welfare Medical, Dental, Vision, Time Loss and Life Claims Processors. This position requires collaboration with other auditors, outside vendors, account executives, department supervisors and managers, and medical consultants. Primary responsibilities for this position include: Perform internal audits of our Health and Welfare Claims Processors' work Design and implement training plans for Claims Processors Conduct training sessions for groups of new Claims Processors Train and cross-train on plan, system and procedural changes Respond to day-to-day referral questions Perform random and large dollar claims audits Prepare written claim processing guideline materials Coordinate vendor interaction with specific PPOs and benefit providers This position has a hybrid work schedule with 3 days per week in office, after the completion of training. The position can be based in the Seattle, Mountlake Terrace or Federal Way office. Eligibility: This position is open to current employees who are located within the Greater Seattle area. Only local candidates will be considered. Relocation assistance is not available.
Requirements
- Educated. Bachelor's degree preferred or equivalent combination of education & experience
- Experienced. Medical & Dental Claims processing; auditing/training experience preferred
- Organized. Able to prioritize work, multi-task and work independently
- Communicator. Excellent verbal, written and interpersonal communication skills
- Technically Savvy. Intermediate level experience using Microsoft Office Suite of tools
Responsibilities
- Perform internal audits of our Health and Welfare Claims Processors' work
- Design and implement training plans for Claims Processors
- Conduct training sessions for groups of new Claims Processors
- Train and cross-train on plan, system and procedural changes
- Respond to day-to-day referral questions
- Perform random and large dollar claims audits
- Prepare written claim processing guideline materials
- Coordinate vendor interaction with specific PPOs and benefit providers
Benefits
- Hourly rate range of $30.70 - $41.54 per hour (dependent upon experience & qualifications)
- Medical, dental (w/Orthodontia), vision, Rx benefits, disability & life insurance
- Optional benefits: health flex spending, dependent care assistance & pet insurance
- Generous 401(k) plan with employer base contribution and match
- Paid Vacation (10 days), Sick Leave (10 days) and Holidays (10 days)
- Collaborative team environment
- Work-life balance
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Industry
Insurance Carriers and Related Activities
Number of Employees
501-1,000 employees
