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Case Auditor Jobs (NOW HIRING)

Phelps Health

Nurse Auditor Reviewer

The Nurse Auditor performs appeal writing, reviews, and other tasks that may be assigned by the ... Cross trains to other roles within the department, in particular insurance review and case ...

State-of-Maine

Senior Auditor

Augusta, ME · On-site

$67 - $95/hr

As a Senior Auditor you will:Work on the Internal Audit team monitoring all audits of the ... case reviews.Assist Management in the annual planning and implementing of work schedules and work ...

Phelps Health

Nurse Auditor Reviewer

Phelps, NY · Hybrid

The Nurse Auditor performs appeal writing, reviews, and other tasks that may be assigned by the ... Cross trains to other roles within the department, in particular insurance review and case ...

State of Maine

Senior Auditor

Augusta, ME · On-site

$67K - $95K/yr

As a Senior Auditor you will: * Work on the Internal Audit team monitoring all audits of the ... case reviews. * Assist Management in the annual planning and implementing of work schedules and ...

Heritage Grocers Group

Auditor ELR

Addison, TX · On-site

The auditor will also identify mispicks and missing cases, verify the individual case weights on the frozen and fresh meat pallets, and alert the applicable selector when an error is discovered. Upon ...

WRIGHT WISNER DISTRIBUTING CORP

Shipping Auditor

Le Roy, NY · On-site

$18.90 - $24.57/hr

Wright Beverage Distributing is looking for a Shipping Auditor to join our team! You will receive ... case of can (21 pounds), 1 case of 12oz bottles (38 pounds), 1 case of 40 oz bottles (48 pounds ...

University Health

Coding Educator/Auditor

San Antonio, TX · Remote

$25.10 - $40.25/hr

Completion of a coding program from other licensing bodies shall be accepted on a case by case ... The Coding Educator & Auditor must maintain a valid credential offered by the accrediting bodies ...

TEKsystems

Coding Auditor (CPC)

Baltimore, MD · Hybrid

$66K - $92K/yr

Medical Coding Auditor Hybrid (1 - 2 days in office per week) Baltimore, MD 21201 Compensation $66k ... Document and track compliance cases, investigations, and inquiries within the case management ...

WRIGHT WISNER DISTRIBUTING CORP

Shipping Auditor

Le Roy, NY · On-site

$18.90 - $24.57/hr

Wright Beverage Distributing is looking for a Shipping Auditor to join our team! You will receive ... case of can (21 pounds), 1 case of 12oz bottles (38 pounds), 1 case of 40 oz bottles (48 pounds ...

University Health

Coding Educator/Auditor

San Antonio, TX · On-site

$25.10 - $40.25/hr

Completion of a coding program from other licensing bodies shall be accepted on a case by case ... The Coding Educator & Auditor must maintain a valid credential offered by the accrediting bodies ...

University Health

Coding Educator/Auditor

San Antonio, TX · Remote

$23.50 - $26.75/hr

Completion of a coding program from other licensing bodies shall be accepted on a case by case ... The Coding Educator & Auditor must maintain a valid credential offered by the accrediting bodies ...

Elevance Health

DRG Clinical Auditor Principal

Mason, OH · On-site

$122K - $183K/yr

The DRG Clinical Auditor Principal is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG) methodology, including case rate and per diem ...

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Case Auditor information

See salary details

$30.5K

$72.6K

$117.5K

How much do case auditor jobs pay per year?

As of Sep 6, 2026, the average yearly pay for case auditor in the United States is $72,633.00, according to ZipRecruiter salary data. Most workers in this role earn between $47,000.00 and $98,500.00 per year, depending on experience, location, and employer.

What is a case auditor?

Case Auditors are professionals who review and evaluate case files, records, or processes to ensure accuracy, compliance, and quality. They often work in legal, healthcare, insurance, or social services settings, where they check that cases are handled according to established standards and regulations. Their work helps identify errors, inefficiencies, or areas for improvement, contributing to better organizational performance. Case Auditors may also provide feedback or recommendations based on their findings to support quality assurance initiatives.

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

To thrive as a Case Auditor, you need strong analytical skills, attention to detail, and a solid understanding of compliance regulations, often supported by a background in accounting, auditing, or a related field. Familiarity with audit management software, database systems, and relevant certifications such as Certified Internal Auditor (CIA) are typically required. Exceptional organizational, communication, and critical thinking skills help auditors effectively review cases and report findings. These competencies are crucial for ensuring accurate assessments, maintaining regulatory compliance, and supporting organizational integrity.

What are some common challenges faced by case auditors, and how can they be addressed?

Case Auditors often encounter challenges such as managing large caseloads, staying current with regulatory changes, and ensuring thorough documentation. Balancing accuracy with efficiency can be demanding, especially when deadlines are tight. To address these challenges, it's important to develop strong organizational skills, keep up with ongoing training, and maintain open communication with team members and stakeholders. Collaborating with colleagues and leveraging auditing tools can also help streamline workflows and ensure high-quality results.

What is the difference between Case Auditor vs Claims Processor?

AspectCase AuditorClaims Processor
Required CredentialsTypically requires a background in insurance, auditing, or related certificationsOften requires knowledge of claims processing systems and insurance policies
Work EnvironmentOffice setting, reviewing cases, auditing claims for accuracyOffice environment, processing insurance claims and data entry
Employer & Industry UsageInsurance companies, third-party administratorsInsurance companies, healthcare providers, government agencies
Comparison Search IntentUnderstanding auditing roles in claims reviewLearning about claims processing tasks

The main difference between a Case Auditor and a Claims Processor lies in their focus. A Case Auditor reviews and verifies insurance claims for accuracy and compliance, often performing audits and quality checks. In contrast, a Claims Processor handles the initial processing of claims, entering data, and ensuring claims are correctly submitted. Both roles are essential in the insurance industry but serve different stages of the claims management process.

More about Case Auditor jobs

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

The top searched job categories for Case Auditor jobs are:

Case Auditor jobs near you
Infographic showing various Case Auditor job openings in the United States as of August 2026, with employment types broken down into 2% As Needed, 79% Full Time, 17% Part Time, and 2% Contract. Highlights an 88% Physical, 3% Hybrid, and 9% Remote job distribution, with an average salary of $72,633 per year, or $34.9 per hour.

Nurse Auditor Reviewer

Phelps Health

Remote

Full-time

Posted 10 days ago

Phelps Health rating

6.4

Company rating: 6.4 out of 10

Based on 36 frontline employees who took The Breakroom Quiz

648th of 898 rated healthcare providers

Job description

Phelps Health is a 2000-employee-strong hospital and healthcare system serving the heart of small-town Missouri.

No matter where you start with us, we're committed to taking our team to the top. If you're ready for the challenge of providing life-saving care or supporting those who do, read on to find your fit in the Phelps Health family.

General Summary

  • This position supports the Denial, Prevention, and Recovery Department (DPR) by providing Clinical Data Analyst and Review services. The Nurse Auditor performs appeal writing, reviews, and other tasks that may be assigned by the Denial and Prevention Director. Also serves as a contact person/liaison between auditors/external resources. Evaluates trends in denials, high risk areas and provides education.

Essential Duties and Responsibilities

  • Retrieves patient medical records to compile all requested documentation in the format stipulated and within the timeframe requested by CMS.
  • Tracks audit requests/appeals/due dates/correspondence and communicates with payer/auditor.
  • Compiles and presents reports on behalf of the Denial & Prevention Department.
  • Writes appeals, works with providers to obtain letters of medical necessity for appeal work, reviews records for medical necessity.
  • Manages departmental correspondence, mail, and tracking spreadsheets.
  • Cross trains to other roles within the department, in particular insurance review and case management.
  • Develops front end education and training to related denials.

Education

  • Graduate of an accredited Associates or Bachelor's Nursing program required. Training in Microsoft EXCEL highly preferred.


Work Experience

  • At least 3 years of clinical experience. Experience with utilization management, disccharge planning, and third party payors preferred. Must be computer literate and have knowledge and understanding of psycho/social needs.


Certification/License

  • Missouri or Compact State RN Licensure required.
  • Case Management certification preferred.

Mental/Physical Requirements

  • Considerable mental concentration. Ability to receive and express detailed information through oral and written communications. Excellent interpersonal and organizational skills.


Working Conditions

  • hybrid remote work
  • must be able to work collaboratively with stakeholders, speaking in public at times

At Phelps Health, we think we have a better team, benefits, and opportunities for growth than anyone else around, and we invite you to see for yourself! Apply now to join us on our mission in health care.

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