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Health Insurance Auditor Jobs (NOW HIRING)

L.A. Insurance

Insurance Auditor

Birmingham, MI · On-site

We offer competitive pay and generous benefits, including paid time off, paid holidays, health insurance options and retirement participation. The Audit Specialist conducts policy audits and overall ...

Suffolk County Government

Auditor

Hauppauge, NY · On-site

$54K - $88K/yr

The exam is "Auditor" Please Proceed As Follows: * Locate at the top right side of the site in the ... Health Insurance: Suffolk offers a comprehensive health insurance plan, including medical, dental ...

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Health Insurance Auditor information

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$17

$26

$45

How much do health insurance auditor jobs pay per hour?

As of Jul 1, 2026, the average hourly pay for health insurance auditor in the United States is $26.24, according to ZipRecruiter salary data. Most workers in this role earn between $18.51 and $34.38 per hour, depending on experience, location, and employer.

What is a Health Insurance Auditor?

A Health Insurance Auditor is a professional responsible for reviewing and evaluating healthcare claims, billing records, and insurance documents to ensure accuracy, compliance with regulations, and prevention of fraud. They analyze medical records and insurance policies to verify that services billed are medically necessary and properly documented. Their work helps healthcare organizations, insurance companies, and government agencies maintain financial integrity and comply with healthcare laws and standards.

What does an insurance auditor do?

A health insurance auditor reviews insurance claims, policies, and financial records to ensure accuracy, compliance, and proper billing. They analyze data using auditing tools and may verify that claims meet regulatory standards, helping prevent fraud and errors in insurance processes.

What does an auditor do in healthcare?

A healthcare auditor reviews medical records, billing claims, and insurance documentation to ensure accuracy, compliance with regulations, and proper reimbursement. They analyze data, identify discrepancies, and may use auditing tools or software to support their assessments, often requiring knowledge of healthcare laws and coding standards.

What are some common challenges Health Insurance Auditors face during claim reviews, and how can these be addressed?

Health Insurance Auditors often encounter challenges such as incomplete documentation, discrepancies between provider records and claims, and keeping up with frequently changing regulations. These issues can be addressed by maintaining up-to-date knowledge of industry standards, developing strong attention to detail, and fostering good communication with healthcare providers to clarify information. Additionally, utilizing audit management software and participating in regular training can help auditors stay organized and efficient in their reviews.

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

To thrive as a Health Insurance Auditor, you need a solid understanding of healthcare billing, auditing procedures, and regulatory compliance, typically supported by a degree in healthcare administration, accounting, or a related field. Familiarity with claims management systems, electronic health records (EHRs), and certifications like Certified Professional Medical Auditor (CPMA) are common requirements. Attention to detail, analytical thinking, and effective communication are essential soft skills for identifying discrepancies and explaining audit findings. These skills and qualifications ensure accurate claims processing, regulatory compliance, and the prevention of fraud or financial loss for healthcare organizations and insurers.

What type of auditor gets paid the most?

In the field of health insurance auditing, senior or lead auditors with extensive experience and specialized certifications tend to earn the highest salaries. Auditors working for large organizations or in managerial roles generally receive higher pay, especially if they have expertise in compliance, data analysis, or regulatory standards.

What is the difference between Health Insurance Auditor vs Claims Examiner?

AspectHealth Insurance AuditorClaims Examiner
CredentialsCertifications like CPC, CPC-H, or CIA often preferredCertifications like CPC or claims-specific training common
Work EnvironmentTypically in offices, performing audits on claims and recordsUsually in claims departments reviewing and processing claims
Industry UsageUsed across insurance companies, government agencies, and consulting firmsPrimarily employed by insurance companies and healthcare providers

Health Insurance Auditors focus on reviewing claims and records for accuracy and compliance, often conducting audits to prevent fraud and ensure proper billing. Claims Examiners process and review individual claims for payment. While both roles involve claims, auditors have a broader scope, including compliance and auditing standards, whereas examiners handle day-to-day claim processing.

How to become a health insurance auditor?

To become a health insurance auditor, candidates typically need a bachelor's degree in accounting, finance, or a related field. Relevant experience in insurance, auditing, or healthcare is often required, along with strong analytical skills and knowledge of insurance regulations. Professional certifications such as Certified Internal Auditor (CIA) or Certified Public Accountant (CPA) can enhance job prospects.
More about Health Insurance Auditor jobs
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What states have the most Health Insurance Auditor jobs? States with the most job openings for Health Insurance Auditor jobs include:
What job categories do people searching Health Insurance Auditor jobs look for? The top searched job categories for Health Insurance Auditor jobs are:
Health Insurance Auditor jobs near you

Premium Insurance Auditor

ARMStrong Insurance Services

Toledo, OH • On-site

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 7 days ago

Key responsibilities

  • Conduct premium audits for Workers' Comp, General Liability, Garage, and Auto policies.

  • Review financial records and apply audit standards.

  • Schedule and perform on-site audits within assigned territory.

Job description

ARMStrong Insurance Services is the leading and most trusted name in the world of debt recovery and financial solutions. With a track record of excellence and reliability, we have proudly served businesses across various industries for decades, ensuring efficient B2B collections and tailored debt recovery solutions. As the parent company, ARMStrong is proud to own and operate Brown & Joseph, Paragon, SubroIQ, and NEIS, each a powerhouse in their own right, providing specialized expertise in debt management and financial services.
NEIS, LLC a leader in the insurance audit and loss control prevention industry since 1945 is seeking a Premium Auditor to grow our team. Premium Auditors examine the financial records of businesses insured by commercial property and casualty insurers. As a premium auditor, your primary responsibilities will be looking for evidence of fraud and checking that insured businesses adhere to regulations. You will work from home but are required to travel to each policyholder's location within a limited territory.
Job Responsibilities: 

  • Conduct premium audits for Workers’ Comp, General Liability, Garage, and Auto policies
  • Review financial records and apply audit standards
  • Schedule and perform on-site audits within assigned territory
  • Communicate with policyholders to gather required documentation
  • Identify discrepancies and ensure compliance
  • Prepare and submit audit reports
Job Requirements:
  • Associate’s degree or equivalent experience preferred
  • 2+ years of premium audit experience (preferred)
  • Strong analytical and communication skills
  • Proficiency in Microsoft Excel and Word (Visual Audit and Nexus Audit a plus)
  • Valid driver’s license and reliable transportation
  • Personal auto insurance meeting minimum requirements: $100,000 bodily injury per person; $300,000 per accident (or $300,000 combined single limit)

Compensation and Benefits:
  • Benefit package with health, dental, vision, 401k and more
  • Exceptional training program
  • Flexible schedule
  • Continuing education reimbursements for premium auditing certifications with bonuses after completion
  • Generous paid time off policy and 7 paid holidays 
  • Mileage Reimbursements
  • Compensation consists of base wage and production bonus paid weekly
    • Billable hour rates vary based on experience and knowledge – range is $44 -$50 per billable hour
    • Earning potential is only limited by your drive and resilience - potential of $75k+

We look forward to you joining our team!
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ARMStrong Insurance Services is an Equal Opportunity Employer. We do not discriminate on the basis of race, color, religion, marital status, age, national origin, ancestry, physical or mental disability, medical​​​ condition, pregnancy, genetic information, gender, sexual orientation, gender identity or ​expression, veteran status, or any other status protected under federal, state, or local law.

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