Medical Claims Auditor (Hybrid)

Northwest Administrators, Inc.; Seattle (WA); Hybride; USD 42 000 - 57 000; Plein temps

Avantages offerts par ce poste

Medical benefits

Dental & Vision

Rx benefits

Life insurance

401(k) plan

Paid time off

Holidays

Résumé du poste

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.

Responsabilités

• 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.

Connaissances

Verbal communication

Written communication

Interpersonal skills

Organizational skills

MS Office

Formation

Bachelor's degree or equivalent

Outils

Microsoft Office

Description du poste

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 person we're seeking for our Claims Auditor position!

What you'll be doing...

As a Claims Auditor in our Health & Welfare group, your main focus will be to audit the work completed by the processors for Medical, Dental, Vision, Time Loss and Life insurance claims. This position requires collaboration with other auditors, outside vendors, account executives, department supervisors and managers, and medical consultants.

Primary responsibilities for this position include:

• 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
• Coordinate vendor interaction with specific PPOs and benefit providers

NOTE: This position will be on-site in the Seattle office during the training period. A hybrid work schedule (3 days per week in office) is available upon successful completion of training.

Who you are...

• Educated. Bachelor's degree preferred, or equivalent combination of education & experience
• Experienced. Medical & Dental Claims processing; auditing/training experience preferred
• Organized. Able to prioritize work, multi-task and work independently
• Communicator. Excellent verbal, written and interpersonal communication skills
• Technically Savvy. Intermediate level experience using Microsoft Office Suite of tools

Who we are…

Northwest Administrators, Inc. is an industry leader in third-party administration of employee benefits. We administer one of the largest multi-employer pension plans in the country, along with numerous large health and welfare plans. As part of our team, you will benefit from many training and development opportunities and can expect a better-than-market benefits package. See what our associates are saying about us at Northwest Administrators Inc. | Careers (nwadmin.com)

If hired, you can expect...

• Hourly rate range of $30.70 - $41.54 per hour (dependent upon experience & qualifications)
• 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

NWA is proud to be an Equal Employment Opportunity employer. All employment decisions are based on business needs, job requirements and individual qualifications, without regard to race, color, religion, national origin, sex, sexual orientation, gender identity or expression, age, physical or mental disability, marital status, amnesty, veteran status, citizenship, family medical history or genetic information or any other characteristic protected by local, state, or federal laws. NWA prohibits any discrimination or harassment based on any of these characteristics.

We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. Please contact Human Resources at [e-mail] to request accommodation.