Medical Claims Auditor (Hybrid)

Northwest Administrators • Seattle, WA

24d • Hybrid

About The Position

The Claims Auditor works in the Health & Welfare group, auditing the work of processors handling Medical, Dental, Vision, Time Loss, and Life insurance claims. The role collaborates with fellow auditors, outside vendors, account executives, department supervisors and managers, and medical consultants. It also supports processor accuracy, compliance, and performance through training, guidance, and written materials.

The position is on-site in the Seattle office during training. After successful completion of training, a hybrid schedule is available, with three days per week in the office.

Requirements

• Medical and Dental Claims processing experience.
• Ability to prioritize work, multitask, and work independently.
• Excellent verbal, written, and interpersonal communication skills.
• Intermediate-level experience using Microsoft Office tools.

Nice To Haves

• Bachelor's degree, or an equivalent combination of education and experience.
• Claims auditing and training experience.

Responsibilities

• Perform internal audits of 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 staff 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

• Medical, dental (with orthodontia), vision, prescription, disability, and life insurance benefits.
• Optional health flexible spending, dependent care assistance, and pet insurance.
• 401(k) plan with employer base contribution and match.
• 10 days of paid vacation, 10 days of sick leave, and 10 paid holidays.
• Training and development opportunities.
• Collaborative team environment.
• Work-life balance.

What This Job Offers

• Job Type: Full-time