Medical Claims Auditor (Hybrid)
About The Position
Are you a skilled communicator with strong writing abilities and deep, hands-on experience processing medical claims? Do you enjoy applying your claims expertise to work one-on-one or in small group settings to help others strengthen their accuracy, compliance, and performance? If so, you may be the ideal candidate for our Claims Auditor position within our Health & Welfare group. What you'll be doing... 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. This position has a hybrid work schedule with 3 days per week in the office, after completion of training. The position can be based in our Seattle, Mountlake Terrace or Federal Way office.
Requirements
- Bachelor's degree preferred or equivalent combination of education & experience
- Medical & Dental Claims processing; auditing/training experience preferred
- Able to prioritize work, multi-task and work independently
- Excellent verbal, written and interpersonal communication skills
- Intermediate level experience using Microsoft Office Suite of tools
Nice To Haves
- Medical & Dental Claims processing; 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
- 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
Mid Level
