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 this describes you, 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.
- Communicate appeal outcomes clearly 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-office and can be based in our Seattle, Mountlake Terrace or Federal Way office.
Who you are...
- Educated. Bachelor's degree (preferred) or combination of relevant education & experience
- Experienced. Experience in health & welfare plans, claims processing and medical coding
- Analytical. Interpret detailed information from multiple benefit 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)
- Excellent medical, dental (w/orthodontia), vision, Rx benefits, disability & life insurance
- Optional benefits: health flex spending, dependent care assistance plans & pet insurance
- Generous 401(k) plan with company base contribution & match
- Paid Vacation (10 days), Sick Leave (10 days) and Holidays (10 days)
- Work-life balance
Equal Employment Opportunity
NWA is proud to be an Equal Employment Opportunity employer. All employment decisions are based on business needs, job requirements and individual qualifications, without regard to race, color, religion, national origin, sex, sexual orientation, gender identity or expression, age, physical or mental disability, marital status, amnesty, veteran status, citizenship, family medical history or genetic information or any other characteristic protected by local, state, or federal laws. NWA prohibits any discrimination or harassment based on any of these characteristics.
We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. Please contact Human Resources at [email protected] to request accommodation.
Northwest Administrators Inc. | Privacy Policy (nwadmin.com)
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What We Do
NWA's mission is to provide outstanding service and solutions through knowledge, innovation, dedication & excellence.
Having been in business for over 50 years as a third party administrator (TPA) of employee benefit programs, we can proudly say we have never lost a client due to service related issues.
Our skilled employees are essential in maintaining our position as an industry leader. We strive to create a positive working environment that values:
•Diversity: Our differences, unique talents and varied backgrounds come together to create a stronger whole.
•Working Smart: We encourage innovation and continuous improvement to promote efficiency and accuracy.
•Positive Attitudes: Our professional behavior creates a positive first impression that is lasting for both employees and clients.
•Teamwork: We build each other up; and share our successes, failures, information and ideas.
We have 6 office locations strategically located in large metropolitan areas (Seattle, Portland, Las Vegas, Brisbane, San Francisco & Pasadena). This allows our employees to take advantage of the innovation and diversity that surrounds them and also enables us to hire the best talent in the industry.
Our success and longevity comes from our strength and knowledge in administering Taft Hartley Funds, (including one of the nation’s largest multi-employer defined pension funds) and other multi-employer/association programs, including: Pension plans, Medical, Dental, Vision, Prescription drug, Life, AD&D & Short term disability benefits.
Our high ethical standards and strong focus on customer service cause many to make NWA their career choice-- working here 10, 15, and 20 years or more!
