ZipRecruiter

Log In

1

Appeals Auditor Jobs (NOW HIRING)

Northwell Health

Appeals Specialist

Lake Success, NY · On-site

$66K - $108K/yr

Auditing experience with DRGs. Responds to commercial payers, managed care and third party review organizations in managing the appeals/denials process. Supports the review of denial trends and ...

UHS

APPEALS SPECIALIST

Las Vegas, NV · On-site

$22.16 - $29.36/hr

  • Medical

  • Dental

  • Vision

  • Retirement

... Auditors to support medical necessity appeals. This position requires preparing and submitting accurate appeal documentation, conducting thorough research to gather supporting evidence, and ensuring ...

UHS

APPEALS SPECIALIST

Las Vegas, NV

  • Medical

  • Dental

  • Vision

  • Retirement

... Auditors to support medical necessity appeals. This position requires preparing and submitting accurate appeal documentation, conducting thorough research to gather supporting evidence, and ensuring ...

Northwell

Appeals Specialist

Lake Success, NY · On-site

$66K - $108K/yr

Auditing experience with DRGs. Responds to commercial payers, managed care and third party review organizations in managing the appeals/denials process. Supports the review of denial trends and ...

Northwell Health

Appeals Specialist

Lake Success, NY · On-site

Auditing experience with DRGs. Responds to commercial payers, managed care and third party review organizations in managing the appeals/denials process. Supports the review of denial trends and ...

UHS

APPEALS SPECIALIST

Las Vegas, NV · On-site

  • Medical

  • Dental

  • Vision

  • Retirement

... Auditors to support medical necessity appeals. This position requires preparing and submitting accurate appeal documentation, conducting thorough research to gather supporting evidence, and ensuring ...

owensboroworkdaytest

APPEALS SPECIALIST

Owensboro, KY · On-site

Composes credible appeal letters, utilizing: Federal and State regulations; Center for Medicare and ... Collaborates extensively with Business Office/HIM/Auditing/Finance/Medical Director of Case ...

UHS

APPEALS SPECIALIST

Las Vegas, NV

  • Medical

  • Dental

  • Vision

  • Retirement

... Auditors to support medical necessity appeals. This position requires preparing and submitting accurate appeal documentation, conducting thorough research to gather supporting evidence, and ensuring ...

Northwell

Appeals Specialist

Lake Success, NY

Auditing experience with DRGs. Responds to commercial payers, managed care and third party review organizations in managing the appeals/denials process. Supports the review of denial trends and ...

UHS

APPEALS SPECIALIST

Las Vegas, NV · On-site

  • Medical

  • Dental

  • Vision

  • Retirement

... Auditors to support medical necessity appeals. This position requires preparing and submitting accurate appeal documentation, conducting thorough research to gather supporting evidence, and ensuring ...

LIBERTY DENTAL

$23 - $28.50/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... auditors and regulatory agencies. * Manage administrative and operational support for Quality ... Minimum 3 years of experience in grievance and appeals, healthcare law, dental law, or a related ...

Curana Health, Inc.

Manage appeals and grievance cases from intake through final resolution, including receiving, logging, tracking, monitoring, documenting, requesting supporting documentation, investigating, auditing ...

City of Alexandria

Business Tax Auditor

Alexandria, VA · On-site

$63K - $84K/yr

The Business Tax Auditor performs interviews or conferences with taxpayers and business ... Conduct, analyze, and resolve complex business tax appeals, including maintaining both case and ...

previous pagenext page

Showing results 21-40

All JobsLegal JobsLaw Office and Legal Clinic JobsLegal Analyst JobsAppeals Auditor Jobs

Appeals Auditor information

See salary details

$33K

$76.3K

$121.5K

How much do appeals auditor jobs pay per year?

As of Aug 18, 2026, the average yearly pay for appeals auditor in the United States is $76,256.00, according to ZipRecruiter salary data. Most workers in this role earn between $53,500.00 and $98,500.00 per year, depending on experience, location, and employer.

What is an appeals auditor?

Appeals Auditors are professionals who review and evaluate appeals related to insurance claims, healthcare billing, or other administrative decisions. They examine documentation, verify compliance with relevant regulations and policies, and determine whether the original decision should be upheld or overturned. Appeals Auditors play a crucial role in ensuring fairness and accuracy in the appeals process, often working for insurance companies, healthcare providers, or government agencies. Their work helps maintain integrity and trust in organizational procedures.

What are the key skills and qualifications needed to thrive as an appeals auditor, and why are they important?

To thrive as an Appeals Auditor, you need a strong understanding of healthcare regulations, claims processing, and auditing principles, often supported by a degree in healthcare administration or a related field. Proficiency with claims management software, EHR systems, and familiarity with HIPAA and CMS guidelines are typically required. Analytical thinking, attention to detail, and effective communication are essential soft skills for reviewing complex cases and collaborating with stakeholders. These skills ensure accurate and compliant appeals processing, minimizing financial risk and supporting organizational integrity.

What are some common challenges appeals auditors face when reviewing complex cases, and how can they overcome them?

Appeals Auditors often encounter challenges such as interpreting ambiguous documentation, ensuring compliance with rapidly changing regulations, and balancing accuracy with efficiency under tight deadlines. To overcome these hurdles, auditors typically rely on thorough training, regular updates on industry guidelines, and collaboration with subject matter experts or legal teams. Effective communication and attention to detail are essential, as is staying organized to manage multiple cases simultaneously. Proactively seeking clarification and participating in team discussions can also help resolve uncertainties and improve the quality of audits.

What is the difference between Appeals Auditor vs Claims Processor?

CriteriaAppeals AuditorClaims Processor
Required credentialsTypically requires auditing, accounting, or claims processing certificationsUsually needs claims processing or insurance-related certifications
Work environmentAuditing departments, insurance companies, or healthcare organizationsClaims departments within insurance companies or healthcare providers
Employer and industry usageUsed in insurance, healthcare, and government agencies for compliance and accuracyCommonly employed in insurance companies handling claim submissions and payments
Search and comparison intentOften compared for roles involving review and compliance of claimsCompared for roles focused on processing and managing claims

While both Appeals Auditors and Claims Processors work within the insurance and healthcare industries, Appeals Auditors primarily review and verify the accuracy of claims during appeals, ensuring compliance and correctness. Claims Processors handle the initial processing of claims, focusing on data entry and payment. Understanding these differences helps job seekers identify roles aligned with their skills and career goals.

More about Appeals Auditor jobs

What cities are hiring for Appeals Auditor jobs?

Cities with the most Appeals Auditor job openings:

What states have the most Appeals Auditor jobs?

States with the most job openings for Appeals Auditor jobs include:

What job categories do people searching Appeals Auditor jobs look for?

The top searched job categories for Appeals Auditor jobs are:

Appeals Auditor jobs near you
Infographic showing various Appeals Auditor job openings in the United States as of August 2026, with employment types broken down into 89% Full Time, 8% Part Time, 2% Contract, and 1% Nights. Highlights an 88% Physical, 5% Hybrid, and 7% Remote job distribution, with an average salary of $76,256 per year, or $36.7 per hour.

Appeals Specialist

Northwell Health

Lake Success, NY • On-site

$66K - $108K/yr

Full-time

Re-posted 22 days ago

Northwell Health rating

7.8

Company rating: 7.8 out of 10

Based on 564 frontline employees who took The Breakroom Quiz

127th of 888 rated healthcare providers

Job description


Required: Background in Inpatient with 3-5 years' experience in Coding or Auditing.
Highly Preferred: Auditing experience with DRGs.
Job Description
Responds to commercial payers, managed care and third party review organizations in managing the appeals/denials process. Supports the review of denial trends and identifies coding issues and knowledge gaps.
Job Responsibility
  • Supports denial reviews and response processes; prioritizes and reviews cases denied by commercial payers.
  • Reports program performance and/or corrective action to management on regular basis.
  • Assists in monitoring inpatient denial types, volume and formulates responses to requesting agency; seeks additional resources (e.g. legal counsel) to resolve issues, as needed; develops case-specific written rationale to substantiate and communicate findings.
  • Addresses coding issues and knowledge gaps; functions as a organization resource for litigation as related to coding denials.
  • Maintains hospital database.
  • Remains up-to-date on DRG system literature from all agencies.
  • Maintains coding clinic up-dates.
  • Operates under general guidance and work assignments are varied and require interpretation and independent decisions on course of action.
  • Performs related duties as required. All responsibilities noted here are considered essential functions of the job under the Americans with Disabilities Act. Duties not mentioned here, but considered related are not essential functions.

Job Qualification
  • Bachelor's Degree required, or equivalent combination of education and related experience.
  • Current Professional Coder Certification, or Current Coding Professional Certification, or Current Registered Health Information Technician Certification required, plus specialized certifications as needed.
  • 1-3 years of relevant experience, required.
  • Knowledgeable on DRGs, preferred.
  • Proficient in Microsoft Excel, preferred.

*Additional Salary Detail
The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When determining a team member's base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity).

What Northwell Health employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Apply