Medical Claims Auditor (Hybrid) jobs in United States
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Northwest Administrators, Inc · 3 hours ago

Medical Claims Auditor (Hybrid)

Northwest Administrators, Inc. is an industry leader in third-party administration of employee benefits. They are seeking a Claims Auditor to review the work of Health and Welfare Claims Processors, design training plans, and conduct training sessions to improve performance.

ConsultingFinancial Services

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

Qualification

Medical Claims ProcessingAuditing ExperienceTraining SkillsMicrosoft Office SuiteCommunication SkillsOrganizational Skills

Required

Great communicator with strong writing skills
Experience in medical/dental claims processing
Ability to work with people individually and in small group settings
Ability to perform internal audits of Health and Welfare Claims Processors' work
Ability to design and implement training plans for Claims Processors
Ability to conduct training sessions for groups of new Claims Processors
Ability to train and cross-train on plan, system and procedural changes
Ability to respond to day-to-day referral questions
Ability to perform random and large dollar claims audits
Ability to prepare written claim processing guideline materials
Ability to coordinate vendor interaction with specific PPOs and benefit providers
Organized and able to prioritize work, multi-task and work independently
Excellent verbal, written and interpersonal communication skills
Intermediate level experience using Microsoft Office Suite of tools

Preferred

Bachelor's degree preferred or equivalent combination of education & experience
Medical & Dental Claims processing; auditing/training experience preferred

Benefits

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

Company

Northwest Administrators, Inc

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Northwest Administrators is an accounting company providing audit, tax, and financial planning services.

Funding

Current Stage
Late Stage

Leadership Team

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Chris Parker
President and Chief Client Officer
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Jennifer Macallister
Senior Human Resources Business Partner
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Company data provided by crunchbase