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Claims Qa Auditor Jobs (NOW HIRING)

The Claims Quality Assurance Auditor maintains positive working relationships with our internal and external customers, health plan's, providers and/or members by seeking a partnership approach that ...

Claims Quality Assurance

Irving, TX · On-site

$70K - $116K/yr

The Claims Quality Assurance serves as the technical claims expert for the Claims Operations by auditing compliance with established CorVel, industry and carrier claim handling standards. The primary ...

The Quality Assurance Auditor will analyze, document, and report on results to business ... Experience with pharmacy on-line claims processing systems preferred. * Strong analytical, problem ...

$24 - $27/hr

The Quality Assurance Auditor will analyze, document, and report on results to business ... Experience with pharmacy on-line claims processing systems preferred. * Strong analytical, problem ...

The Claims Quality Assurance serves as the technical claims expert for the Claims Operations by auditing compliance with established CorVel, industry and carrier claim handling standards. The primary ...

The Quality Assurance (QA) Auditor is responsible for evaluating the accuracy, completeness, and compliance of Patient Access workflows to support highquality registration practices and reduce ...

To learn more about Baptist Health, visit us at The Quality Assurance (QA) Auditor is responsible for evaluating the accuracy, completeness, and compliance of Patient Access workflows to support ...

WI · On-site

$60 - $80/hr

Qa Auditor Full Time Technical Wittenberg, WI, US Job Title: Quality Assurance Auditor Market Title: Quality Assurance Status: Regular Full-Time FLSA: Non-Exempt JOB SUMMARY This role will ...

QA Auditor

Marana, AZ · On-site

$80 - $100/hr

QA Auditor Full Time Marana, AZ, US 3 days ago Requisition ID: 1226 It's your career, give it wings! Who we are and where we are going: Ascent Aviation Services is one of the largest aviation ...

Quality Assurance Auditor Market Title: Quality Assurance Location: Wittenberg WI Status: Regular Full-Time FLSA: Non-Exempt JOB SUMMARY: This role will proactively ensure that the Nueske Quality and ...

JOB SUMMARY The Quality Assurance Auditor is responsible for scheduling, conducting, and assessing the company's Quality Management System. This role covers business processes, including management ...

The QA Auditor will ensure the accuracy, integrity, and compliance of toxicological research studies, with a focus on rodent models (mice and rats). This position requires strong auditing and QA ...

Requirements Must have a minimum of 5 years of Quality Assurance auditing experience in cGMP environment with a minimum of 5 years of external vendor/ supplier compliance auditing experience within ...

Quality Assurance Auditor Market Title: Quality Assurance Location: Wittenberg WI Status: Regular Full-Time FLSA: Non-Exempt JOB SUMMARY: This role will proactively ensure that the Nueske Quality and ...

Quality Assurance Auditor Market Title: Quality Assurance Location: Wittenberg WI Status: Regular Full-Time FLSA: Non-Exempt JOB SUMMARY: This role will proactively ensure that the Nueske Quality and ...

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Claims Qa Auditor information

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As of Sep 9, 2026, the average hourly pay for claims qa 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.

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Infographic showing various Claims Qa Auditor job openings in the United States as of July 2026, with employment types broken down into 91% Full Time, 7% Part Time, and 2% Contract. Highlights an 85% Physical, 5% Hybrid, and 10% Remote job distribution, with an average salary of $55,805 per year, or $26.8 per hour.

Claims Quality Assurance Auditor

Whittier, CA • On-site

PIH Health
Health Care and Social Assistance • 5 - 10K employees

Full-time

Posted 11 days ago


PIH Health rating

8.6

Company rating: 8.6 out of 10

Based on 66 frontline employees who took The Breakroom Quiz

7th of 898 rated healthcare providers


Job description

The Claims Quality Assurance Auditor maintains positive working relationships with our internal and external customers, health plan's, providers and/or members by seeking a partnership approach that will meet the company goals and vision. The CQA auditor will coordinate Health Plan's audits activities with preparation and provide preliminary results on non-compliant issues to CQA manager. Oversees, audit findings and provide education to claims staff and other internal customers within PIH. Assists with developing an audit control checklist for prevention of claims timeliness, payment accuracy, systematic or statistical errors in PIH managed care claims system. Develop a root cause analysis report for common trends to provide feedback to the claims staff/ team and/or PIH internal customers. Oversees, in conjunction with the Managed Care Management Team, to ensure QA programs are aligned with claims operations and other areas that have direct impact with claims to prevent non-compliance. Adheres to internal department standard operating procedures and applies standard industry guidelines in accordance with regulatory agencies (state and federal). Researches, analyzes and resolves complex problems dealing with claims audits, including member denials, provider disputes, deficiencies that will potentially jeopardize the claims department. Has extensive knowledge of current and future claims processing, audits, compliance, adjustment, provider disputes, DOFRs and/or configuration, etc.

PIH Health is a nonprofit, regional healthcare network that serves approximately 3 million residents in the Los Angeles County, Orange County and San Gabriel Valley region. The fully integrated network is comprised of PIH Health Downey Hospital, PIH Health Good Samaritan Hospital, PIH Health Whittier Hospital, 37 outpatient medical office buildings, a multispecialty medical (physician) group, home healthcare services and hospice care, as well as heart, cancer, digestive health, orthopedics, women's health, urgent care and emergency services. The organization is nationally recognized for excellence in patient care and patient experience, and the College of Healthcare Information Management Executives (CHIME) has identified PIH Health as one of the nation's top hospital systems for best practices, cutting-edge advancements, quality of care and healthcare technology. For more information, visit PIHHealth.org or follow us on Facebook, Twitter, or Instagram.


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About PIH Health

Sourced by ZipRecruiter

* PIH Health is a nonprofit health and wellness network serving Los Angeles and Orange Counties. Our integrated system consists of 747 beds at two acute care hospitals and a multi-specialty medical group. * Strong community reputation * 2014, 2015 Favorite Workplace * Innovative, transparent, family-like culture

Industry

Health care and social assistance

Company size

5,001 - 10,000 Employees

Headquarters location

Whittier, CA, US

Year founded

1959