Medical Claims Auditor (Hybrid)
About The Position
Northwest Administrators, Inc. is seeking a skilled communicator with strong writing abilities and deep, hands-on experience processing medical claims for a Claims Auditor position within their Health & Welfare group. This role focuses on reviewing the work of Health and Welfare Medical, Dental, Vision, Time Loss, and Life Claims Processors. The position requires collaboration with other auditors, outside vendors, account executives, department supervisors and managers, and medical consultants. The role involves performing internal audits, designing and implementing training plans, conducting training sessions, responding to referral questions, performing random and large dollar claims audits, preparing written claim processing guideline materials, and coordinating vendor interaction with specific PPOs and benefit providers. This position has a hybrid work schedule with 3 days per week in the office after training completion and can be based in Seattle, Mountlake Terrace, or Federal Way.
Requirements
- Medical & Dental Claims processing experience
- Intermediate level experience using Microsoft Office Suite of tools
- Excellent verbal, written and interpersonal communication skills
- Able to prioritize work, multi-task and work independently
Nice To Haves
- Bachelor's degree preferred or equivalent combination of education & experience
- auditing/training experience preferred
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
- 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)
- Holidays (10 days)
- Collaborative team environment
- Work-life balance
- Training and development opportunities
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
