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Claim Auditor Jobs (NOW HIRING)

Allied

Quality Assurance Auditor

Chicago, IL · On-site +1

$48K - $50K/yr

The QA Auditor is also responsible for auditing outgoing correspondence from the Medical Review, Appeals, and Refund teams, as well as complete audit of claim adjustments by the Rapid Response team.

Allied

Quality Assurance Auditor

Chicago, IL · On-site +1

$48K - $50K/yr

The QA Auditor is also responsible for auditing outgoing correspondence from the Medical Review, Appeals, and Refund teams, as well as complete audit of claim adjustments by the Rapid Response team.

TRG

Dealer Auditor - Pittsburgh

Streetsboro, OH · On-site

The role of the Dealer Auditor is to minimize the company's liability and risk by conducting ... Perform audits of dealer warranty claim submissions through in-depth review of repair order ...

Chubb

Claim Director

Los Angeles, CA · On-site

Respond to internal requests for information from management, reinsurers, auditors, etc. * Prepare timely and accurate reports to management regarding significant claim developments. * Provide the ...

Firstsource

Quality Auditor

- Auditor (HB & PB) Role Auditor - Hospital Billing (HB) & Professional Billing (PB) Role Summary ... Claim status review * Denial handling * Appeals * Underpayment follow-up * Review and evaluate WC ...

Chubb

Claim Director

Philadelphia, PA · On-site

$105K - $179K/yr

Respond to internal requests for information from management, reinsurers, auditors, etc. * Prepare timely and accurate reports to management regarding significant claim developments. * Provide the ...

Chubb

Claim Director

Walnut Creek, CA · On-site

$105K - $179K/yr

Respond to internal requests for information from management, reinsurers, auditors, etc. * Prepare timely and accurate reports to management regarding significant claim developments. * Provide the ...

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Claim Auditor information

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How much do claim auditor jobs pay per hour?

As of Jun 30, 2026, the average hourly pay for claim auditor in the United States is $26.83, according to ZipRecruiter salary data. Most workers in this role earn between $19.71 and $29.81 per hour, depending on experience, location, and employer.

What are claim auditors?

Claim auditors are professionals who review and evaluate insurance claims to ensure their accuracy, legitimacy, and compliance with company policies and regulations. They analyze documentation, verify billing codes, and check for errors or fraud in submitted claims. The goal of a claim auditor is to minimize financial losses for insurers and ensure that policyholders and providers receive fair and proper payments. Claim auditors may work for insurance companies, third-party administrators, or healthcare organizations. Their work helps maintain the integrity of the claims process and supports efficient operations.

What is the difference between Claim Auditor vs Claims Processor?

AspectClaim AuditorClaims Processor
Required CredentialsTypically requires a certification in claims auditing or insuranceOften requires basic insurance or claims processing training
Work EnvironmentOffice setting, reviewing claims for accuracy and complianceOffice or call center, entering and processing claims data
Employer & IndustryInsurance companies, third-party administratorsInsurance companies, healthcare providers

Claim Auditors focus on reviewing and verifying claims for accuracy and compliance, often requiring specialized certifications. Claims Processors handle the entry and initial processing of claims, typically with less emphasis on auditing skills. Both roles are essential in the insurance industry but differ in responsibilities and required credentials.

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

To thrive as a Claim Auditor, you need a strong understanding of insurance policies, claim processing procedures, and attention to detail, typically supported by a degree in business, finance, or a related field. Familiarity with claims management systems, auditing software, and sometimes certifications like Certified Professional Medical Auditor (CPMA) are commonly required. Analytical thinking, integrity, and effective communication are crucial soft skills for investigating claims and collaborating with stakeholders. These skills ensure accurate claim evaluation, fraud prevention, and compliance with regulatory standards.

What are some common challenges faced by Claim Auditors and how can they be addressed?

Claim Auditors often encounter challenges such as reviewing large volumes of complex claim files, interpreting varying policy guidelines, and ensuring compliance with both internal and external regulations. Staying organized and detail-oriented is crucial, as is keeping up-to-date with changes in policies or industry regulations. Effective communication with claims adjusters and other departments helps resolve discrepancies quickly and ensures accurate claim processing. Joining regular training sessions and leveraging audit software tools can also help streamline workflows and reduce errors.
More about Claim Auditor jobs
What cities are hiring for Claim Auditor jobs? Cities with the most Claim Auditor job openings:
What states have the most Claim Auditor jobs? States with the most job openings for Claim Auditor jobs include:
What job categories do people searching Claim Auditor jobs look for? The top searched job categories for Claim Auditor jobs are:
Claim Auditor jobs near you
Infographic showing various Claim Auditor job openings in the United States as of June 2026, with employment types broken down into 1% As Needed, 88% Full Time, 8% Part Time, 1% Temporary, and 2% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $55,805 per year, or $26.8 per hour.
Quality Assurance Auditor

Quality Assurance Auditor

Allied Benefit Systems

Chicago, IL • Remote

Full-time

Medical, Dental, Vision, Life, PTO

Posted 18 days ago

Allied Benefit Systems rating

8.1

Company rating: 8.1 out of 10

Based on 5 frontline employees who took The Breakroom Quiz

87th of 437 rated business services

Job description

POSITION SUMMARY

The Quality Assurance Auditor will be responsible for the completion of multiple audit tasks including but not limited to auditing the building of plan coders as needed for all new and existing revisions, along with compiling and reporting results and trends accurately. The QA Auditor is also responsible for auditing outgoing correspondence from the Medical Review, Appeals, and Refund teams, as well as complete audit of claim adjustments by the Rapid Response team. The QA Auditor will interpret the benefits in the plan documents to determine how benefits are payable and tracked/reported in the QicLink system.

ESSENTIAL FUNCTIONS

Log and track data to be audited

Audit outgoing correspondence from the Medical Review, Appeals, and Refund teams

Conduct complete audit of claim adjustments by the Rapid Response team

Communicate and coordinate with other departments involved in the audit process

Audit new and existing plans built by plan coders for all new and existing revisions

Assist with current audit programs in place as well as identifying ways to improve audit results

Track and report audit trends and communicate training requirements to Management based on audit results

Monitor and track audit progress to ensure all audit tasks are complete by the determined deadline

Audit data for accuracy as well as workflow compliance

Other duties as assigned

EDUCATION

Bachelor's degree or equivalent work experience required.

EXPERIENCE AND SKILLS

Minimum 5 years of comprehensive experience with auditing medical, dental, and vision claims required

Proficient in Microsoft Word and Microsoft Excel

Some familiarity with plan coding

Strong written and verbal communication skills required

Ability to effectively manage assigned workload, including multiple tasks and competing priorities

COMPETENCIES

Accountability

Analytical Thinking

Collaboration

Communication

Customer Focus

Functional Expertise

Initiative

PHYSICAL DEMANDS

This is a standard desk job requiring extended sitting and computer work

.

WORK ENVIRONMENT

Remote

Here at Allied, we believe that great talent can thrive from anywhere. Our remote friendly culture offers flexibility and the comfort of working from home, while also ensuring you are set up for success. To support a smooth and efficient remote work experience, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 100Mbps download/25Mbps upload. Reliable internet service is essential for staying connected and productive.

The company has reviewed this job description to ensure that essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills, and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.

Compensation is not limited to base salary. Allied values our Total Rewards, and offers a competitive Benefit Package including, but not limited to, Medical, Dental, Vision, Life and Disability Insurance, Generous Paid Time Off, Tuition Reimbursement, EAP, and a Technology Stipend.

Allied reserves the right to amend, change, alter, and revise, pay ranges and benefits offerings at any time. All applicants acknowledge that by applying to the position you understand that the specific pay range is contingent upon meeting the qualification and requirements of the role, and for the successful completion of the interview selection and process. It is at the Company's discretion to determine what pay is provided to a candidate within the range associated with the role.

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