ZipRecruiter

Log In

1

Claims Quality Auditor Jobs (NOW HIRING)

UCLA Health

Claims Quality Auditor

Los Angeles, CA · On-site

$31.51 - $62.64/hr

The Claims Quality Auditor will be responsible for the daily audit of all examiners assigned to the auditor. You will review claims (paid, pending, and denied) for accuracy, appropriate application ...

Imagenet

Claims Quality Auditor - Remote

Tampa, FL · On-site +1

Claims Quality Auditor| Remote Job Type: Full time Work Setup: Remote Reports to: Claims Supervisor Position Summary: The Claims Quality Auditor plays a key role in ensuring the accuracy, compliance ...

ImagenetLLC

Claims Quality Auditor - Remote

Tampa, FL · Remote

Claims Quality Auditor| Remote Job Type: Full time Work Setup: Remote Reports to: Claims Supervisor Position Summary: The Claims Quality Auditor plays a key role in ensuring the accuracy, compliance ...

Imagenet

Claims Quality Auditor - Remote

Tampa, FL · Remote

Claims Quality Auditor| Remote Job Type: Full time Work Setup: Remote Reports to: Claims Supervisor Position Summary: TheClaims Quality Auditor plays a key role in ensuring the accuracy, compliance ...

ImageNetLLC

Claims Quality Auditor - Remote

Tampa, FL · Remote

Claims Quality Auditor| Remote Job Type: Full time Work Setup: Remote Reports to: Claims Supervisor Position Summary: TheClaims Quality Auditor plays a key role in ensuring the accuracy, compliance ...

Parkland Health

Performs a detailed quality assurance of claims processed by the Third-Party Administrator (TPA ... Coordinates with the Nurse Auditor for clinical consultations or account referrals when necessary.

New

Chubb

Claims/QC Auditor

Spokane Valley, WA · On-site

$38K - $65K/yr

High School or GED required and at least 6 months as an Claims/QC Assistant at Rain and Hail or at least one year of previous underwriting or claims auditing experience or a baccalaureate degree.

Centivo

Claims Auditor

Buffalo, NY · Remote

$55K - $60K/yr

That is where Centivo comes in -- our mission is to bring affordable, high-quality healthcare to the millions who struggle to pay their healthcare bills. Centivo is seeking a Claims Auditor who will ...

Firstsource

Quality Auditor

- Auditor (HB & PB) Role Auditor - Hospital Billing (HB) & Professional Billing (PB) Role Summary ... Duplicate claims * Timely filing denials * Authorization issues * Provider/NPI-related denials

Firstsource

Quality Auditor

Louisville, KY · On-site

- Auditor (HB & PB) Role Auditor - Hospital Billing (HB) & Professional Billing (PB) Role Summary ... Duplicate claims * Timely filing denials * Authorization issues * Provider/NPI-related denials

Firstsource

Quality Auditor

- Auditor (HB & PB)Role Auditor - Hospital Billing (HB) & Professional Billing (PB) Role Summary ... Duplicate claims * Timely filing denials * Authorization issues * Provider/NPI-related denials

Amcor plc

Quality Auditor

Richmond, VA · On-site

... claims and monitoring supplier performance. • Effectively interacts with all departments ... auditors, and maintains quality system certification. • Maintains and follows all company ...

Amcor

Quality Auditor

Richmond, VA · On-site

Quality Manager Summary: The Quality Auditor serves as the lead quality authority for their ... Responsible for processing vendor claims and monitoring supplier performance. Effectively interacts ...

Curative HR LLC

Senior Auditor, Healthcare Claims

Austin, TX · Remote

$83K - $104K/yr

The Senior Auditor partners closely with Claims Operations, Configuration, Payment Integrity ... Claims Audit & Quality Oversight * Perform comprehensive audits of professional, institutional ...

Curative HR LLC

Senior Auditor, Healthcare Claims

Austin, TX · Remote

$83K - $104K/yr

The Senior Auditor partners closely with Claims Operations, Configuration, Payment Integrity ... Claims Audit & Quality Oversight * Perform comprehensive audits of professional, institutional ...

next page

Showing results 1-20

All JobsClaims Quality Auditor Jobs

Claims Quality Auditor information

See salary details

$14

$26

$47

How much do claims quality auditor jobs pay per hour?

As of Jul 27, 2026, the average hourly pay for claims quality 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 some common challenges faced by Claims Quality Auditors, and how can they be effectively managed?

Claims Quality Auditors often encounter challenges such as interpreting complex policy language, staying updated with evolving regulations, and managing large volumes of claims within tight deadlines. To manage these effectively, auditors should regularly participate in training sessions, use standardized auditing tools, and collaborate closely with claims adjusters and supervisors. Maintaining open communication with team members and leveraging technology for data analysis can also help ensure consistent and accurate audit results.

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

AspectClaims Quality AuditorClaims Examiner
Primary RoleReviews and assesses the accuracy and compliance of claims to improve qualityProcesses and evaluates individual insurance claims for approval or denial
Required CredentialsTypically requires insurance or claims processing certifications, attention to detailOften requires similar certifications, with focus on claim evaluation skills
Work EnvironmentQuality assurance teams, office settings, audits of claims filesClaims departments, customer service environments, direct claim processing

While both roles involve claims, Claims Quality Auditors focus on reviewing and improving claim accuracy and compliance, whereas Claims Examiners handle the initial processing and decision-making on individual claims. Understanding these differences helps in choosing the right career path or job search focus.

What are Claims Quality Auditors?

Claims Quality Auditors are professionals who review and assess insurance claims to ensure they are processed accurately, efficiently, and in compliance with company standards and regulatory requirements. They analyze claim files, identify errors or discrepancies, and provide feedback or recommendations to claims adjusters and management. Their work helps maintain high-quality service, reduce fraudulent claims, and improve overall claims processing within insurance organizations.

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

To thrive as a Claims Quality Auditor, you need a solid understanding of insurance claims processes, regulatory compliance, and quality assurance practices, often supported by experience in claims handling or auditing. Familiarity with claims management systems, auditing software, and industry-specific certifications such as Certified Professional Coder (CPC) or Certified Claims Professional (CCP) is typically required. Strong attention to detail, analytical thinking, and effective communication help auditors identify discrepancies and provide actionable feedback. These skills ensure accuracy, reduce risk, and maintain compliance within insurance operations.
More about Claims Quality Auditor jobs
What job categories do people searching Claims Quality Auditor jobs look for? The top searched job categories for Claims Quality Auditor jobs are:
Claims Quality Auditor jobs near you
Infographic showing various Claims Quality Auditor job openings in the United States as of July 2026, with employment types broken down into 89% Full Time, 8% Part Time, 2% Contract, and 1% Nights. Highlights an 87% Physical, 6% Hybrid, and 7% Remote job distribution, with an average salary of $55,805 per year, or $26.8 per hour.
Claims Quality Auditor

Claims Quality Auditor

UCLA Health

Los Angeles, CA • On-site

$31.51 - $62.64/hr

Full-time

Posted 29 days ago

UCLA Health rating

8.7

Company rating: 8.7 out of 10

Based on 136 frontline employees who took The Breakroom Quiz

7th of 890 rated healthcare providers

Job description

General Information
Press space or enter keys to toggle section visibility
Work Location: Los Angeles, CA, USA
Onsite or Remote
Flexible Hybrid
Work Schedule
Monday - Friday, 8:00am - 4:30pm PST
Posted Date
07/02/2026
Salary Range: $32.76 - 65.13 Hourly
Employment Type
2 - Staff: Career
Duration
N/A
Job #
31617
Primary Duties and Responsibilities
Press space or enter keys to toggle section visibility
Take on an important role within a world-class health organization. Provide specialized expertise that enables the efficient operation of a complex health system. Take your career to the next level. You can do all this and more at UCLA Health.
The Claims Quality Auditor will be responsible for the daily audit of all examiners assigned to the auditor. You will review claims (paid, pending, and denied) for accuracy, appropriate application of benefits, authorization for services, contract interpretation, Division of Financial Responsibility (DOFR), and application/compliance with policies and procedures. You will:
  • Research over and under-payment inquiries/appeals
  • Compile and maintain statistical data consistent
  • Maintain departmental production and quality standards

Salary Range: $31.51 - $62.64 Hourly
Job Qualifications
Press space or enter keys to toggle section visibility
We're seeking a self-motivated, detail-oriented, deadline-driven individual with:
  • High school diploma, GED or equivalent
  • Four or more years of medical claims payment experience in an HMO environment
  • Experience with CPT-4, ICD-9CM, RBRVS, ASA, and HCPCS
  • Understanding of Medicare Guidelines and COB
  • Knowledge of medical terminology
  • Experience in benefit determination and claims adjudication
  • Ability to accurately key 6,000-8,000 keystrokes or type 40-50 WPM
  • Understanding of professional and facility reimbursement methodologies
  • Strong organizational skills
  • Computer proficiency with Microsoft Office
  • Knowledge of claims adjudication systems
  • Flexibility and adaptability

As a condition of employment, the final candidate who accepts an offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; or have filed an appeal of a finding of substantiated misconduct with a previous employer.
Current/former UC employees are subject to a personnel file review.

What UCLA Health employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

UCLA Health logo

About UCLA Health

Sourced by ZipRecruiter

UCLA Health, operating within the healthcare industry, is significantly recognized for its commitment to improving the health and wellbeing of people through the integration of patient care, research, and education. Located in Los Angeles, California, UCLA Health was founded and associated with the University of California, Los Angeles (UCLA) in 1955, entrenching its roots in quality healthcare service provision. Through a broad range of medical services, UCLA Health significantly stands as a cornerstone for comprehensive outpatient, inpatient, and emergency care services, specialized treatments, and wellness checks. Notable for pioneering an integrated, comprehensive medical approach, UCLA Health is consistently ranked among the top health systems in the US and world.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Los Angeles, CA, US

Year founded

1955

View All UCLA Health Jobs

Apply