Medical Claims Auditor (Hybrid)

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

Prepare written claim processing guideline materials

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

Equal Employment Opportunity

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 [email protected] to request accommodation.

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