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Claims Auditor Jobs (NOW HIRING)

Independent Living Systems

Claims Auditor

Miami, FL · On-site

We are seeking a Claims Auditor to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is ...

University Health

Claims Auditor

San Antonio, TX · On-site

$19.55 - $29.75/hr

POSITION SUMMARY/RESPONSIBILITIES Responsible for development and maintenance of claims auditing program for all lines of business to improve claims processing standards and to monitor the quality of ...

Robert Half

Claims Auditor

Omaha, NE · On-site

$55K - $60K/yr

We are looking for a detail-oriented Claims Auditor to join a Financial Services organization in Omaha, Nebraska. In this role, you will evaluate benefit and insurance claim submissions, apply policy ...

Health Source MSO

Claims Auditor

Alhambra, CA

Claims Auditor will be responsible for auditing claims processed by Claims Examiners. Responsibilities include, but not limited to: Maintain up-to-date knowledge of procedures for all ICD-10, CPT ...

Quantix

Healthcare Claims Auditor

Ann Arbor, MI

Job Title: Healthcare Claims Auditor Location: Ann Arbor, MI Type: Contract Length: Through 12/22/2016 Our client in the Ann Arbor, Michigan area is looking for Healthcare Claims Auditors to join ...

Stellantis

Supplier Claims Auditor

Auburn Hills, MI · On-site

The Supplier Claims Auditor is responsible for performing independent audits of supplier cancellation claims to ensure that only contractually obligated and substantiated costs are paid, driving ...

SPECIALTY RX, Inc.

QI CLAIMS AUDITOR

Ridgefield Park, NJ · On-site

$20 - $24/hr

Description CLAIMS AUDITOR We are seeking a Claims Auditor with QI experience to become part of our team! Under general supervision of the QI Manager, and in accordance with local, state, federal and ...

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How much do claims auditor jobs pay per hour?

As of Jun 13, 2026, the average hourly pay for claims 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 Claims Auditors?

Claims Auditors are professionals responsible for reviewing and evaluating insurance claims to ensure accuracy, compliance with regulations, and adherence to company policies. They analyze claim files, verify documentation, and identify any discrepancies or potential fraud. Claims Auditors play a crucial role in minimizing errors, preventing financial losses, and maintaining the integrity of the claims process within insurance companies or healthcare organizations.

Is an auditor a high paying job?

Claims auditors typically earn a median salary that is competitive within the insurance and finance industries, with salaries varying based on experience, location, and certifications. Senior or specialized auditors tend to earn higher wages, and the role often requires attention to detail and knowledge of claims processing systems. Overall, it can be considered a well-paying profession compared to many entry-level jobs.

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

To thrive as a Claims Auditor, you need a strong understanding of insurance claims processes, compliance regulations, and attention to detail, typically supported by a degree in finance, business, or a related field. Familiarity with claims management systems, auditing software, and industry certifications like Certified Professional Medical Auditor (CPMA) can be highly beneficial. Analytical thinking, effective communication, and problem-solving skills help Claims Auditors identify discrepancies and collaborate across departments. These abilities are essential for ensuring accurate claims processing, minimizing errors, and maintaining organizational compliance.

How to get a job as a claims examiner?

To become a claims examiner, candidates typically need a high school diploma or equivalent, with some roles requiring an associate's or bachelor's degree in fields like insurance, finance, or healthcare. Relevant skills include attention to detail, analytical thinking, and knowledge of insurance policies; certifications such as the Certified Claims Examiner (CCE) can enhance job prospects. Employers often seek experience in customer service or administrative roles, and the work environment is usually office-based with standard business hours.

What does a claims auditor do?

A claims auditor reviews insurance claims to ensure accuracy, compliance with policies, and proper documentation. They analyze claim data, identify discrepancies or fraud, and often use auditing software to verify the legitimacy of claims, supporting the claims adjustment process.

What Is the Job of a Claims Auditor?

As a claims auditor, your job is to review, process, and audit all claims, charges, and demands made of your company. Claims auditors usually handle requests for insurance benefits, but you can also work in schools or other industries that have frequent exposure to potential litigation. To accomplish your job, you review proposed claims, gather information, talk to witnesses, examine existing procedures, and otherwise try to determine the validity of an application. You may be asked to determine whether or not purchase orders are in line with policies, resolve problems with duplicate charges, and ensure the proper allocation of goods and services.

What jobs pay 2000 a day?

Claims auditors typically do not earn $2000 a day; such high daily earnings are more common in specialized roles like senior executives, certain consultants, or highly experienced professionals in finance or law. Most claims auditors earn an annual salary that translates to lower daily rates, though top-tier professionals with extensive experience and certifications may reach higher daily earnings through bonuses or consulting fees.

What is the difference between Claims Auditor vs Claims Processor?

AspectClaims AuditorClaims Processor
Required credentialsHigh school diploma or equivalent; some roles may require certifications in insurance or auditingHigh school diploma or equivalent; on-the-job training often provided
Work environmentOffice setting, reviewing claims for accuracy and complianceOffice setting, entering and processing insurance claims
Employer and industry usageInsurance companies, third-party administrators, healthcare providersInsurance companies, healthcare providers, claims processing centers

Claims Auditors focus on reviewing and verifying the accuracy of claims, ensuring compliance with policies and regulations. Claims Processors handle the initial entry and processing of claims, often working under supervision. While both roles are essential in the claims cycle, Claims Auditors have a more analytical and compliance-oriented role, whereas Claims Processors focus on data entry and claim submission.

What are some common challenges faced by Claims Auditors, and how can they be managed effectively?

Claims Auditors often encounter challenges such as tight deadlines, large volumes of complex claims, and the need to stay updated on frequently changing regulations. Managing these challenges effectively requires strong organizational skills, attention to detail, and proactive communication with team members and other departments. Utilizing advanced auditing software and participating in ongoing training can also help Claims Auditors maintain accuracy and efficiency in their reviews.
More about Claims Auditor jobs
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Claims Auditor jobs near you
Infographic showing various Claims Auditor job openings in the United States as of June 2026, with employment types broken down into 100% Full Time. Highlights an 67% In-person, and 33% Remote job distribution, with an average salary of $55,805 per year, or $26.8 per hour.
Claims Auditor

Claims Auditor

Independent Living Systems

Miami, FL • On-site

Full-time

Posted 12 days ago

Independent Living Systems rating

6.5

Company rating: 6.5 out of 10

Based on 8 frontline employees who took The Breakroom Quiz

Job description

We are seeking a Claims Auditor to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations.

The Claims Auditor plays an essential role in ensuring the accuracy, compliance, and integrity of health care claims within the organization. This position involves conducting thorough audits of submitted claims to verify adherence to regulatory standards, contractual obligations, and internal policies. The Claims Auditor will identify discrepancies, potential fraud, and areas for process improvement, thereby safeguarding the organization's financial health and reputation. By collaborating with claims processors, healthcare providers, and compliance teams, the auditor helps to streamline claims management and reduce errors. Ultimately, this role supports the delivery of efficient and ethical services by maintaining transparent and accountable claims operations.

Minimum Qualifications:

  • Bachelor’s degree in Health Administration, or a related field.
  • At least 2 years of experience in claims auditing, health care compliance, or a similar role within the health care industry.
  • Strong knowledge of health care claims processes, insurance billing, and regulatory requirements such as HIPAA and CMS guidelines.
  • Proficiency in audit software and Microsoft Office Suite, particularly Excel for data analysis.
  • Relevant experience may substitute for the educational requirement on a year-for-year basis.

Preferred Qualifications:

  • Master’s degree in Health Administration, or a related field.
  • Certification such as Certified Internal Auditor (CIA), Certified Professional Coder (CPC), or Certified Healthcare Auditor (CHA).
  • Experience with claims management software.
  • Familiarity with fraud detection techniques and health care fraud prevention programs.
  • Demonstrated ability to lead audit projects or mentor junior auditors.

Responsibilities:

  • Demonstrate commitment to Our Mission and models ILS Experience Standards of Excellence.
  • Conduct detailed audits of healthcare claims to ensure accuracy, compliance with regulations, and adherence to organizational policies.
  • Analyze claim data and documentation to identify errors, inconsistencies, or potential fraud.
  • Prepare comprehensive audit reports with findings, recommendations, and corrective actions for management and stakeholders.
  • Collaborate with claims teams and healthcare providers to resolve discrepancies and drive process improvements.
  • Stay updated on healthcare regulations and industry best practices, while supporting internal and external audits with relevant documentation and insights.
  • Perform other duties as assigned.