Medical Claims Auditor (Hybrid)

The role

You will audit work completed by processors for Medical, Dental, Vision, Time Loss and Life insurance claims. You will also design and implement training plans and coordinate vendor interaction.

What you will do

• Perform internal audits of 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

• Medical & Dental Claims processing
• 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

Nice to have

• Bachelor's degree
• Auditing/training experience

Benefits

• Medical, dental (w/Orthodontia), vision, Rx benefits, disability & life insurance
• 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)
• Holidays (10 days)

About the company

Northwest Administrators, Inc. is an industry leader in third-party administration of employee benefits. They administer one of the largest multi-employer pension plans in the country and numerous large health and welfare plans.