Medical Claims Auditor (Hybrid)

Northwest Administrators, Inc. • Seattle, WA

1d • Hybrid

About The Position

This position focuses on reviewing the work of Health and Welfare Medical, Dental, Vision, Time Loss, and Life Claims Processors. It involves collaboration with other auditors, outside vendors, account executives, department supervisors and managers, and medical consultants. The role requires performing internal audits, designing and implementing training plans, conducting training sessions, staying updated on plan/system/procedural changes, responding to referral questions, performing claims audits, preparing written claim processing guideline materials, and coordinating vendor interactions with PPOs and benefit providers. This is a hybrid position 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
• Ability to prioritize work, multi-task and work independently

Nice To Haves

• Auditing/training experience preferred
• Bachelor's degree preferred or equivalent combination of education & 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 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) and Holidays (10 days)
• Collaborative team environment
• Work-life balance
• Training and development opportunities

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree