HybridOn-site in the Seattle office during training; hybrid schedule with 3 office days per week after successful completion of training.
InsuranceClaims Adjudication
About the job
Requirements
Equivalent combination of education and experience is accepted; a bachelor's degree is preferred.
Experience processing medical and dental claims is required.
Ability to prioritize work, multitask, and work independently.
Strong verbal, written, and interpersonal communication skills.
Intermediate-level experience using Microsoft Office Suite tools.
Responsibilities
Perform internal audits of Health and Welfare Claims Processors' work for Medical, Dental, Vision, Time Loss, and Life insurance 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.
Prepare written claim-processing guideline materials.
Coordinate vendor interaction with specific PPOs and benefit providers.
Collaborate with other auditors, outside vendors, account executives, department supervisors and managers, and medical consultants.
Desired Qualifications
Auditing and training experience is preferred.
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
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.