Medical Claims Auditor (Hybrid)

Position Overview

Northwest Administrators, Inc. is seeking a proactive Health and Welfare Claims Auditor to join their team. In this role, you will review the work completed by Medical, Dental, Vision, Time Loss, and Life Claims Processors, collaborate with auditors, account executives, supervisors, and external vendors, and design and implement training plans to ensure quality and compliance. Strong communication skills and the ability to work both independently and as part of a team are essential.

Key Responsibilities

• 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

Required Qualifications

• Education: Bachelor's degree preferred or equivalent combination of education & experience
• Experience Required: 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

Benefits & Perks

• Salary: $30.70 - $41.54 per hour (dependent upon experience & qualifications)
• Location: Seattle, Mountlake Terrace or Federal Way office
• Schedule: Hybrid (3 days per week in office after training)
• 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 and work-life balance