Medical Claims Auditor (Hybrid)
Position Summary & Responsibilities
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 ou
Key Role Competencies & Evaluation Highlights
Interviewers intensely scrutinize compliance accuracy, operational resilience, and your ability to manage high-stakes administrative accuracy within strict regulatory frameworks.
Apply for Medical Claims Auditor (Hybrid)
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