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Appeals Auditor Jobs (NOW HIRING)

Stefanini Group

Appeals Intake Coordinator

Grand Rapids, MI · Hybrid

$17.25 - $23.50/hr

The Appeals intake coordinator position is focused on the processing of incoming member and ... This team member may also participate in auditing and monitoring activities as assigned. This team ...

Stefanini Group

Appeals Intake Coordinator

Grand Rapids, MI · Hybrid

$17.25 - $23.50/hr

The Appeals intake coordinator position is focused on the processing of incoming member and ... This team member may also participate in auditing and monitoring activities as assigned. This team ...

Stefanini Group

Appeals Intake Coordinator

Grand Rapids, MI · Hybrid

$17.25 - $23.50/hr

The Appeals intake coordinator position is focused on the processing of incoming member and ... This team member may also participate in auditing and monitoring activities as assigned. This team ...

Adventist Health

Chart Auditor (Portland)

Portland, OR · On-site

Chart Auditor Adventist Health Portland is looking for a Chart Auditor for full-time, day shift. We ... Audits clinical denials to determine root cause, trends, and opportunities for appeal, and ...

UCLA Health

Claims Quality Auditor

Los Angeles, CA · On-site

$31.51 - $62.64/hr

The Claims Quality Auditor will be responsible for the daily audit of all examiners assigned to the ... Research over and under-payment inquiries/appeals * Compile and maintain statistical data ...

EAGLE Certification Group

Aerospace Lead Auditor

Dayton, OH · Remote

$120K - $200K/yr

... appeal to you?Turn your industry experience into a legacy. As an Aerospace auditor, you don't just ... check boxes, you play a critical role in enhancing passenger safety and driving the future of ...

Evolve Therapy Services

Compliance Auditor (SNF)

Cleveland, OH · On-site

$50K - $65K/yr

  • Medical

  • Dental

  • Vision

  • PTO

The COMPLIANCE AUDITOR is responsible for assisting with the therapy audit/appeals process, including but not limited to, completing therapy audits, identifying trends, providing education, and ...

Evolve Therapy Services

Compliance Auditor (SNF)

Canonsburg, PA · On-site

$50K - $60K/yr

  • Medical

  • Dental

  • Vision

  • PTO

The COMPLIANCE AUDITOR is responsible for assisting with the therapy audit/appeals process, including but not limited to, completing therapy audits, identifying trends, providing education, and ...

Evolve Therapy Services

Compliance Auditor (SNF)

Toledo, OH

$50K - $60K/yr

  • Medical

  • Dental

  • Vision

  • PTO

The COMPLIANCE AUDITOR is responsible for assisting with the therapy audit/appeals process, including but not limited to, completing therapy audits, identifying trends, providing education, and ...

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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 Intake Coordinator

Stefanini Group

Grand Rapids, MI • Hybrid

$17.25 - $23.50/hr

Contractor

Posted 8 days ago

Job description

Stefanini Group is hiring!
Stefanini is looking for Appeals Intake Coordinator-Remote 100%
For quick apply, please contact Rahul Kumar; Ph: 248 936 5060
Rahul.kumar@stefanini.com
 
W2 Candidates Only!
 
Job Summary:
The Appeals intake coordinator position is focused on the processing of incoming member and provider Medicare appeals and grievances. This team member will screen incoming complaints and appeals for level of urgency, benefit or medical necessity issues and other appropriate inquiries. This team member will assign the incoming concern to the appropriate analyst and may assist in investigations, documentation gathering, and correspondence as needed. This team member may also participate in auditing and monitoring activities as assigned. This team member will promote quality member care and customer service/satisfaction.
 
This team member will interact with Customer Service, Utilization Management, Medical Directors, and other internal teams as necessary to effectively triage incoming complaints and appeals.
 
Essential Functions:
  • Review and triage incoming Medicare appeals and grievances based on urgency and type of concern.
  • Assign incoming complaints, appeals, and inquiries to the appropriate analyst for review and resolution.
  • Assist with investigations, documentation collection, and correspondence related to appeals and grievances.
  • Correspond with members, providers, and regulatory agencies regarding decisions and actions.
  • Collaborate with Customer Service, Utilization Management, Medical Directors, and other internal teams to effectively manage incoming concerns.
  • Participate in auditing and monitoring activities as assigned.
  • Communicate, collaborate, and cooperate with internal and external stakeholders.
  • Promote quality member care and customer service satisfaction.
  • Adhere to all compliance requirements and HIPAA regulations.
  • Support departmental goals that contribute to the overall success of the organization.

Qualifications:
Education:
  • High School Diploma or equivalent required.
 
Experience:
  • Minimum of one (1) year of health insurance or managed care experience performing Appeals and Grievances functions.
 
Knowledge, Skills, and Abilities:
  • Knowledge of healthcare delivery systems.
  • Ability to work in a fast-paced environment with changing priorities.
  • Strong collaboration and teamwork skills.
  • Effective written communication skills.
  • Strong time management and prioritization skills.
  • Demonstrated problem-solving abilities.
  • Strong organizational skills and attention to detail.
  • Ability to identify and define problems, gather and analyze information, establish facts, draw valid conclusions, and implement changes related to federal regulations.
 
Technical Skills:
  • Proficiency with Microsoft Office applications.
  • Experience with Health Edge, Epic, and/or Facets preferred.
 
#LI-RK1
#LI-HYBRID
 
 
Stefanini takes pride in hiring top talent and developing relationships with our future employees. Our talent acquisition teams will never make an offer of employment without having a phone conversation with you. Those face-to-face conversations will involve a description of the job for which you have applied. We also speak with you about the process including interviews and job offers.
 
About Stefanini Group:
The Stefanini Group is a global provider of offshore, onshore and near shore outsourcing, IT digital consulting, systems integration, application, and strategic staffing services to Fortune 1000 enterprises around the world. Our presence is in countries like the Americas, Europe, Africa, and Asia, and more than four hundred clients across a broad spectrum of markets, including financial services, manufacturing, telecommunications, chemical services, technology, public sector, and utilities. Stefanini is a CMM level 5, IT consulting company with a global presence. We are CMM Level 5 company
Education:OtherEmployment Type: CONTRACTOR

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