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Claims Auditor Jobs in Remote, OR (NOW HIRING)

CONFEDERATED TRIBES OF CLUSI

Pharmacy Biller

Coos Bay, OR

$17.25 - $22.25/hr

This role reviews claims, resolves denials, and supports patients with billing and insurance ... Maintains accurate and complete billing documentation and records for auditing and reporting ...

All JobsClaims Auditor JobsClaims Auditor Jobs in Remote, OR

Claims Auditor information

See Remote, OR salary details

$14

$26

$47

How much do claims auditor jobs pay per hour?

As of Sep 3, 2026, the average hourly pay for claims auditor in Remote, OR is $26.80, according to ZipRecruiter salary data. Most workers in this role earn between $19.71 and $29.76 per hour, depending on experience, location, and employer.

What is a claims auditor?

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.

What does a claims auditor do?

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 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.

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.

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.

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Claims Auditor jobs near you
Infographic showing various Claims Auditor job openings in Remote, OR as of August 2026, with employment types broken down into 1% Internship, 86% Full Time, 10% Part Time, and 3% Contract. Highlights an 70% Physical, 4% Hybrid, and 26% Remote job distribution, with an average salary of $55,750 per year, or $26.8 per hour.

Bluespine-Payment Accuracy and Concept Lead (AI-Driven)

Team8

OR • On-site, Remote

Full-time

Re-posted 4 days ago

Job description

Description
Bluespine is an innovative new startup in the health-IT domain. By employing cutting-edge technologies, Bluespine is developing an engine that detects errors in medical billing, which causes billions of dollars in losses across the entire industry. Bluespine can offer personalized precision by tailoring assessments to each unique medical claim, considering the relevant provider, payer, and plan, and ensuring unparalleled accuracy.
We are looking for a Payment Accuracy and Concept Lead to discover medical billing errors and fraudulent billing patterns of medical claims for commercial payers.
Utilized Bluespine platform to develop and enhance new audit concepts using healthcare. Leads concept creation across multiple audit verticals, collaborating with R&D for testing
Responsibilities
  • Leverages the Bluespine platform to develop and refine new audit concepts in healthcare. Leads concept creation across multiple audit verticals.
  • Works closely with Medical Coders, Data Sciences, and Engineering teams to ensure alignment and drive impactful results
  • Lead in-depth research of new ideas and concepts

Requirements
  • Extensive knowledge of medical terminology, medical records, health information management, medical coding, DRG methodologies, CPT/HCPCS coding guidelines, physician specialty guidelines, reimbursement programs, claims adjudication processes, member contract benefits, and provider billing systems and practices.
  • Previous auditing or consulting experience in a provider or payer environment is preferred

Advantages
  • Registered Nurse required; Bachelor's or Graduate degree
  • Previous auditing or consulting experience with self-insured companies

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