Full-Time

Appeals Specialist

Medical Claims

NorthWest Administrators

NorthWest Administrators

Compensation Overview

$30.70 - $41.54/hr

+ 401(k) Match

Seattle, WA, USA + 2 more

More locations: Lynnwood, WA, USA | Federal Way, WA, USA

Hybrid

Hybrid work schedule with three days per week in-office.

Bachelor's

Category
Customer Experience & Support (1)
Requirements
  • Bachelor’s degree or combination of relevant education and experience
  • Medical claims processing and/or appeals experience (highly preferred)
  • Analytical abilities to interpret and retain detailed information from multiple plan descriptions
  • Problem-solving skills with great attention to detail
  • Excellent interpersonal, written and verbal communication skills
  • Organizational skills and ability to manage competing priorities
Responsibilities
  • Review and process member and provider appeals, ensuring accuracy and adherence to policies
  • Analyze claims, benefits, contracts and regulations to make informed appeal decisions
  • Collaborate with internal teams to prepare and present appeal cases for resolution
  • Clearly communicate appeal outcomes to members, providers and representatives
  • Provide guidance and support to members and providers on appeal procedures
  • This position has a hybrid work schedule with 3 days per week in the office
  • The position can be based in our Seattle, Mountlake Terrace or Federal Way office
NorthWest Administrators

NorthWest Administrators

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