Claims Auditor & Trainer – Health & Welfare (Hybrid)

Northwest Administrators, Inc.; Seattle (WA); Hybrid; USD 42,000 - 57,000; Full time

Benefits offered by this job

Medical benefits

Dental & Vision

Rx benefits

Life insurance

401(k) plan

Paid time off

Holidays

Job summary

Northwest Administrators, Inc. is seeking a Claims Auditor to audit Health & Welfare claims and to design and deliver training for Claims Processors.

The role involves collaborating with auditors, vendors, account executives, supervisors and medical consultants to ensure accuracy, compliance and performance in processing Medical, Dental, Vision, Time Loss and Life claims. The position will require on-site training in Seattle, with a hybrid schedule (3 days in the office) after training.

Qualifications

• Bachelor's degree preferred or equivalent combination of education and experience.
• Experience with Medical & Dental Claims processing; auditing/training preferred.
• Excellent verbal, written and interpersonal communication skills.
• Strong organizational skills; ability to multi-task and work independently.
• Proficient in Microsoft Office Suite.

Responsibilities

• Audit the work of Health & Welfare Claims Processors for Medical, Dental, Vision, Time Loss and Life claims.
• 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.
• Coordinate vendor interactions with PPOs and benefit providers.

Skills

Verbal communication

Written communication

Interpersonal skills

Organizational skills

MS Office

Education

Bachelor's degree or equivalent

Tools

Microsoft Office

Job description

Northwest Administrators, Inc. is seeking a Claims Auditor to audit Health & Welfare claims and to design and deliver training for Claims Processors.

The role involves collaborating with auditors, vendors, account executives, supervisors and medical consultants to ensure accuracy, compliance and performance in processing Medical, Dental, Vision, Time Loss and Life claims. The position will require on-site training in Seattle, with a hybrid schedule (3 days in the office) after training.