Medical Claims Auditor (Hybrid)

Northwest Administrators, Inc. • Seattle, WA

25d • $31 - $42 • Hybrid

About The Position

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

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

Requirements

• Bachelor's degree preferred, or an equivalent combination of education and experience.
• 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 Suite tools.

Nice To Haves

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

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level