Do you enjoy working with a great team of people? Do you provide exceptional service even when having to solve issues that may be complex and difficult? Does the phrase "details matter" describe your approach to everything? If you answered "YES" then you may be the person we're seeking for our Appeals Specialist position!
What you'll be doing...
The Appeals Specialist will assist in the operations of the Health and Welfare Claims Department and will primarily focus on member disputes and appeals.
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.
Who you are...
Educated. Bachelor's degree or combination of relevant education and experience
Experienced. Medical claims processing and/or appeals experience highly preferred
Analytical. Interpret and retain detailed information from multiple plan descriptions
Problem Solver. Strong analytical problem solver with great attention to detail
Communicator. Excellent interpersonal, written and verbal communication skills
Organized. Exceptional organizational skills and ability to manage competing priorities
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 our team, you will benefit from many training and development opportunities and can expect a better-than-market benefits package. See what our associates are saying about us at Northwest Administrators Inc. | Careers (nwadmin.com)
If hired, you can expect...
Hourly rate range of $30.70 - $41.54 per hour (dependent on experience & qualifications)
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 company base contribution & match