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Health Insurance Auditor Jobs in Michigan (NOW HIRING)

Joella's Hot Chicken

Night Auditor

Ann Arbor, MI · On-site

$14.75 - $19.50/hr

Multiple Health Insurance and Life Insurance options 401k Plan + Company Match Paid Parental Leave ... EDUCATION AND EXPERIENCE Minimum of 1 year in Accounting or Night Auditor role Knowledge of PMS ...

Schulte

Night Auditor

Ann Arbor, MI · On-site

$14.75 - $19.50/hr

Multiple Health Insurance and Life Insurance options 401k Plan + Company Match Paid Parental Leave ... EDUCATION AND EXPERIENCE Minimum of 1 year in Accounting or Night Auditor role Knowledge of PMS ...

Contact Government Services, LLC

Auditor

Detroit, MI

$50K - $100K/yr

Auditor Employment Type: Full-Time, Mid-Level Department: Financial CGS is seeking a highly skilled ... Therefore, we offer a comprehensive benefits package. - Health, Dental, and Vision - Life Insurance ...

Contact Government Services, LLC

Auditor

Detroit, MI

Auditor Employment Type: Full-Time, Mid-Level Department: Financial CGS is seeking a highly skilled ... Therefore, we offer a comprehensive benefits package. - Health, Dental, and Vision - Life Insurance ...

Schulte Companies

Night Auditor

Ann Arbor, MI

$14.75 - $19.50/hr

* Schulte Hospitality Group is seeking a dynamic, service-oriented Night Auditor to join our team ... Multiple Health Insurance and Life Insurance options 401k Plan + Company Match Paid Parental Leave ...

Schulte Companies

Night Auditor

Ann Arbor, MI · On-site

$14.75 - $19.50/hr

* Schulte Hospitality Group is seeking a dynamic, service-oriented Night Auditor to join our team ... Multiple Health Insurance and Life Insurance options 401k Plan + Company Match Paid Parental Leave ...

Stellantis

Quality Process Auditor

Auburn Hills, MI

OEM or dealer network experience Our Benefits -- Designed with You in Mind Comprehensive Health ... An employer contribution, even if you don't contribute Income Protection & Insurance Options ...

Joella's Hot Chicken

Night Auditor

Ann Arbor, MI

$14.75 - $19.50/hr

* Schulte Hospitality Group is seeking a dynamic, service-oriented Night Auditor to join our team ... Multiple Health Insurance and Life Insurance options 401k Plan + Company Match Paid Parental Leave ...

Acrisure, LLC

Senior Auditor

Grand Rapids, MI · On-site

$77K - $95K/yr

Insurance accounting background a plus  * 4+ years financial services experience, through ... Health Savings Account (HSA) and Flexible Spending Account (FSA) options; commuter benefits; and ...

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Health Insurance Auditor information

See Michigan salary details

$15

$22

$39

How much do health insurance auditor jobs pay per hour?

As of Aug 1, 2026, the average hourly pay for health insurance auditor in Michigan is $22.87, according to ZipRecruiter salary data. Most workers in this role earn between $16.15 and $29.95 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 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 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.

What are popular job titles related to Health Insurance Auditor jobs in Michigan? For Health Insurance Auditor jobs in Michigan, the most frequently searched job titles are:
What job categories do people searching Health Insurance Auditor jobs in Michigan look for? The top searched job categories for Health Insurance Auditor jobs in Michigan are:
Health Insurance Auditor jobs near you
Infographic showing various Health Insurance Auditor job openings in Michigan as of July 2026, with employment types broken down into 11% Locum Tenens, 75% Full Time, 8% Part Time, 2% Contract, 2% Nights, and 2% Summer. Highlights an 87% Physical, 6% Hybrid, and 7% Remote job distribution, with an average salary of $47,566 per year, or $22.9 per hour.

Auditor, Healthcare Services (Remote in MI)

Molina Healthcare

Detroit, MI • Remote

Full-time

Posted 10 days ago

Molina Healthcare rating

8.0

Company rating: 8.0 out of 10

Based on 197 frontline employees who took The Breakroom Quiz

161st of 300 rated insurance

Job description

JOB DESCRIPTION 

This position will offer remote work flexibility, but the selected candidate must reside in Michigan. 

Opportunity for an RN who has a US license in good standing to join our Medicaid Team as a Clinical Auditor.  The person filling this role will be an instrumental part of the team work to align the Medicaid Team compliance guidelines with those followed by our corporate teams.  Knowledge and experience working with Waiver Program is vital to success in this role. 

The preferred candidate will have 3 - 5 years of experience in a MCO and at least 2 years of clinical auditing and/or review experience. Mastery of Microsoft Office, especially Excel, PowerPoint will also be skill sets we are seeking.  Licensure should be an LPC, RN, LLMSW, LMSW, LBSW.

Hours are Monday - Friday, 8:30AM - 5PM EST. 

Job Summary

Provides support for healthcare services clinical auditing activities. Performs audits for clinical functional areas in alignment with regulatory requirements - ensuring quality compliance and desired member outcomes. Contributes to overarching strategy to provide quality and cost-effective member care. 

Essential Job Duties


Performs audits in utilization management, care management, member assessment, behavioral health, and/or other clinical teams, and monitors clinical staff for compliance with National Committee for Quality Assurance, Centers for Medicare and Medicaid Services (CMS), and state/federal guidelines and requirements. May also perform non-clinical system and process audits as needed. 
Audits for clinical gaps in care from a medical and/or behavioral health perspective to ensure member needs are being met. 
Assesses clinical staff regarding appropriate clinical decision-making. 
Reports monthly outcomes, identifies areas of re-training for staff, and communicates findings to leadership. 
Ensures auditing approaches follow a Molina standard in approach and tool use. 
Maintains member/provider confidentiality in compliance with the Health Insurance Portability and Accountability Act (HIPAA), and professionalism in all communications. 
Adheres to departmental standards, policies and protocols. 
Maintains detailed records of auditing results. 
Assists healthcare services training team with developing training materials or job aids as needed to address findings in audit results. 
Meets minimum production standards related to clinical auditing. 
May conduct staff trainings as needed.  Communicates with quality and/or healthcare services leadership regarding issues identified, and works collaboratively to subsequently resolve/correct. 

Required Qualifications

At least 2 years health care experience, with at least 1 year experience in utilization management, care management, and/or managed care, or equivalent combination of relevant education and experience.

Clinical licensure and/or certification required ONLY if required by state contract, regulation, business operating model, or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice.

Strong attention to detail and organizational skills.

Strong analytical and problem-solving skills.

Ability to work in a cross-functional, professional environment.

Ability to work on a team and independently. Excellent verbal and written communication skills.

Microsoft Office suite/applicable software program(s) proficiency.

Preferred Qualifications


Utilization management, care management, behavioral health and/or long-term services and supports (LTSS) clinical review/auditing experience.
 

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. 
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

What Molina Healthcare employees say

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About Molina Healthcare

Sourced by ZipRecruiter

Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Long Beach, CA, US

Year founded

1980

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