Hybrid Appeals & Claims Analyst

Northwest Administrators, Inc.; Federal Way (WA); Híbrido; USD 42.000 - 57.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical, dental, vision, Rx

Disability & life insurance

401(k) with company match

Paid Vacation (10 days) and Sick Leave

Holidays (10 days)

Descripción de la vacante

Northwest Administrators, Inc. is seeking an Appeals Specialist to support the Health and Welfare Claims Department, focusing on member disputes and appeals. A bachelor’s degree or combination of relevant education and experience is preferred, with strong analytical and communication skills required.

The role offers a hybrid schedule with 3 days per week in the office, and can be based in Seattle, Mountlake Terrace, or Federal Way. We provide competitive benefits and opportunities for growth.

Formación

• Bachelor’s degree or combination of relevant education and experience.
• Medical claims processing and/or appeals experience preferred.
• Ability to interpret and retain detailed information from multiple plan descriptions.
• Excellent interpersonal, written and verbal communication skills.

Responsabilidades

• Review and process member and provider appeals with accuracy.
• Analyze claims, benefits, contracts and regulations to decide appeal decisions.
• Collaborate with internal teams to present appeal cases for resolution.
• Clearly communicate appeal outcomes to members, providers and representatives.
• Provide guidance and support on appeal procedures.

Educación

Bachelor's degree

Combination of education and experience

Analytical thinking

Problem solving

Communication skills

Organizational skills

Interpersonal skills

Descripción del empleo

Northwest Administrators, Inc. is seeking an Appeals Specialist to support the Health and Welfare Claims Department, focusing on member disputes and appeals. A bachelor’s degree or combination of relevant education and experience is preferred, with strong analytical and communication skills required.

The role offers a hybrid schedule with 3 days per week in the office, and can be based in Seattle, Mountlake Terrace, or Federal Way. We provide competitive benefits and opportunities for growth.