Hybrid Health Claims Appeals Specialist

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

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

401(k) plan

Paid time off

Job summary

Northwest Administrators, Inc. is seeking an Appeals Specialist to assist in the Health and Welfare Claims Department, focusing on member disputes and appeals.

Responsibilities include reviewing appeals, analyzing claims and contracts, collaborating with internal teams, and communicating outcomes to members and providers. The role offers a hybrid schedule with three days in the office and options to base in Seattle, Mountlake Terrace, or Federal Way.

Qualifications

• Bachelor's degree or equivalent education/experience.
• Medical claims processing/appeals experience preferred.
• Strong analytical skills and attention to detail.
• Excellent interpersonal, written and verbal communication.
• Organized with ability to manage competing priorities.

Responsibilities

• Review and process member and provider appeals in line with policies.
• Analyze claims, benefits, contracts and regulations to decide appeals.
• Collaborate with internal teams to prepare and present appeal cases.
• Clearly communicate outcomes to members, providers and representatives.
• Provide guidance on appeal procedures to members and providers.

Skills

Analytical

Communication

Organized

Problem solving

Attention to detail

Education

Bachelor's degree or equivalent education/experience

Job description

Northwest Administrators, Inc. is seeking an Appeals Specialist to assist in the Health and Welfare Claims Department, focusing on member disputes and appeals.

Responsibilities include reviewing appeals, analyzing claims and contracts, collaborating with internal teams, and communicating outcomes to members and providers. The role offers a hybrid schedule with three days in the office and options to base in Seattle, Mountlake Terrace, or Federal Way.