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Claims Quality Assurance Jobs (NOW HIRING)

PIH Health

Claims Quality Assurance Auditor

Whittier, CA · On-site

$23 - $36.70/hr

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 ...

LoanCare

QUALITY ASSURANCE CLAIMS SPECIALIST - REMOTE

$22.45 - $37.69/hr

Overview The Quality Assurance Claims Specialist reviews FHA, VA, USDA, and supplemental claims prior to submission to ensure accuracy, completeness, and compliance with all agency and regulatory ...

Westfield

QA & Compliance Senior Specialist

Manhattan, NY

$90K - $125K/yr

This role will report to the VP, Specialty Claims Compliance and will be responsible for supporting Specialty Claims through quality assurance, compliance oversight, claims governance, and ...

Westfield

QA & Compliance Senior Specialist

Manhattan, NY · On-site

$90K - $125K/yr

This role will report to the VP, Specialty Claims Compliance and will be responsible for supporting Specialty Claims through quality assurance, compliance oversight, claims governance, and ...

Astrana Health

Lead - Claims Operations

Monterey Park, CA · Hybrid

$27 - $32/hr

In collaboration with the Claims QA and Training Specialist, claims lead, responsible for ensuring that Claims Representatives have a thorough understanding of Company claims adjudication policies ...

HealthEdge

Claims Quality Auditor

$44K - $50K/yr

Share QA results with individual associates, coordinate with operational Team Leads and managers to ... Maintain currency on CMS claims processing rules and guidelines for Medicare Advantage ...

HealthEdge

Claims Quality Auditor

$44K - $50K/yr

Share QA results with individual associates, coordinate with operational Team Leads and managers to ... Maintain currency on CMS claims processing rules and guidelines for Medicare Advantage ...

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All JobsFinance and Insurance JobsInsurance JobsInsurance Claims Specialist JobsClaims Quality Assurance Jobs

Claims Quality Assurance information

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$15

$44

$64

How much do claims quality assurance jobs pay per hour?

As of Sep 7, 2026, the average hourly pay for claims quality assurance in the United States is $44.87, according to ZipRecruiter salary data. Most workers in this role earn between $36.54 and $54.57 per hour, depending on experience, location, and employer.

What is claims quality assurance?

Claims Quality Assurance (QA) is a process within insurance and related industries that ensures claims are processed accurately, efficiently, and in compliance with company policies and regulatory requirements. Professionals in this role review and audit claims files, identify errors or inconsistencies, and recommend improvements to claim handling procedures. Their work helps reduce errors, prevent fraud, and maintain high standards of customer service.

What skills and qualifications are needed for claims quality assurance?

To thrive as a Claims Quality Assurance professional, you need a solid understanding of insurance claims processes, attention to detail, and experience with quality assurance methodologies, often supported by a relevant degree or industry certifications. Familiarity with claims management systems, auditing tools, and standards such as ISO 9001 is typically required. Strong analytical skills, effective communication, and problem-solving abilities help you excel in reviewing claims and providing constructive feedback. These skills ensure accuracy, compliance, and efficiency in claims handling, which are critical for minimizing errors and reducing financial risk.

What are common challenges in claims quality assurance and how can they be managed?

One common challenge in Claims Quality Assurance is ensuring consistency across a high volume of claims reviews while adhering to ever-evolving regulatory standards. QA professionals may also encounter discrepancies in documentation or incomplete data, which can complicate the review process. To manage these challenges, it's important to stay current with industry regulations, maintain clear communication with claims adjusters, and utilize standardized checklists or audit tools. Regular training and collaboration with other departments help ensure best practices are followed and errors are minimized.

What is the difference between Claims Quality Assurance vs Claims Examiner?

AspectClaims Quality AssuranceClaims Examiner
CertificationsCertifications like CPC or similar are commonCertifications like CPC or similar are common
Work EnvironmentTypically office-based, focusing on review and auditsOffice or remote, handling claim processing and review
Employer & IndustryInsurance companies, third-party administratorsInsurance companies, healthcare providers

Claims Quality Assurance professionals focus on reviewing and auditing claims to ensure accuracy and compliance, while Claims Examiners process and evaluate individual claims for approval or denial. Both roles require similar certifications and work in insurance environments, but their core responsibilities differ: QA specialists focus on quality control, whereas examiners handle claim decisions.

More about Claims Quality Assurance jobs

What cities are hiring for Claims Quality Assurance jobs?

Cities with the most Claims Quality Assurance job openings:

What states have the most Claims Quality Assurance jobs?

States with the most job openings for Claims Quality Assurance jobs include:

What job categories do people searching Claims Quality Assurance jobs look for?

The top searched job categories for Claims Quality Assurance jobs are:

Claims Quality Assurance jobs near you
Infographic showing various Claims Quality Assurance job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 14% Part Time, 3% Contract, and 1% Nights. Highlights an 91% Physical, 1% Hybrid, and 8% Remote job distribution, with an average salary of $93,338 per year, or $44.9 per hour.

Remote Claims Quality Assurance Specialist

Integra Partners

Troy, MI • On-site

$60 - $80/hr

Other

Posted 6 days ago

Job description

Integra Partners in Troy, Michigan is seeking a Claims Quality Assurance Analyst. This role involves monitoring and documenting production quality related to claims auditing and interactions within the Revenue Cycle Management (RCM) function. The ideal candidate should have prior healthcare claims auditing experience and a strong understanding of claims billing practices.

The Analyst will support quality outcomes by identifying audit findings and collaborating with operations to reduce defects. This position offers a dynamic work environment with opportunities for personal development and growth.

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