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$45

How much do health insurance auditor jobs pay per hour?

As of Aug 23, 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 are the key skills and qualifications needed to thrive as a health insurance auditor?

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 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 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 do you 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, healthcare, or auditing, along with knowledge of healthcare regulations and auditing standards, is important. Professional certifications such as Certified Internal Auditor (CIA) or Certified Public Accountant (CPA) can enhance job prospects.

What do you need to be a health insurance auditor?

To become a health insurance auditor, candidates typically need a bachelor's degree in accounting, finance, or a related field, along with experience in healthcare or insurance. Strong analytical skills, attention to detail, and knowledge of insurance regulations and billing practices are essential. Certifications such as Certified Healthcare Auditor (CHA) can enhance job prospects.

What does a health insurance auditor do in healthcare?

A health insurance auditor reviews healthcare claims, billing records, and policy compliance to ensure accuracy and prevent fraud. They analyze data using auditing tools and often require knowledge of healthcare regulations and insurance policies to verify that services billed match provided care and adhere to coverage guidelines.
More about Health Insurance Auditor jobs

What cities are hiring for Health Insurance Auditor jobs?

Cities with the most Health Insurance Auditor job openings:

What states have the most Health Insurance Auditor jobs?

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Health Insurance Auditor jobs near you
Infographic showing various Health Insurance Auditor job openings in the United States as of August 2026, with employment types broken down into 2% As Needed, 76% Full Time, 16% Part Time, and 6% Contract. Highlights an 95% Physical, 1% Hybrid, and 4% Remote job distribution, with an average salary of $54,574 per year, or $26.2 per hour.

Field Insurance Auditor

Information Providers, Inc

Peoria, IL • On-site

$42K - $55K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 29 days ago

Job description

Hiring: Field Insurance Auditor
Company: Information Providers, Inc.
Location: Peoria, IL
At Information Providers Inc. (IPI), we believe great work starts with great people. Since 1996, we've established ourselves as a leader in Property & Casualty and Premium Audit information services, serving insurance companies nationwide through innovative technology and experienced professionals. With over 430 employees and a unique field force supported by regional offices, we deliver accurate, high-quality information. Our core values, service, reliability, flexibility, timeliness, and innovation, drive our growth and foster a supportive workplace. At IPI, your ideas matter, your growth is supported through mentorship and opportunity, and your contributions make a meaningful impact every day. Join us and be part of a team that values its people as much as its purpose!
What You'll Do As Our Full-time Field Insurance Auditor:
  • Dispatch daily to job sites directly from your home
  • Schedule and coordinate client appointments with efficiency and professionalism
  • Perform both field-based and remote audits across a variety of business environments
  • Examine payroll records, financial statements, and operational data
  • Evaluate findings to ensure compliance and accuracy
  • Compile and finalize audit reports along with all necessary documentation

Qualifications:
  • Proficiency with technology, computers, video conference software, and Microsoft-based programs
  • Professional attitude, team spirit, and effective verbal/written communication skills
  • Ability to manage multiple responsibilities, stay organized, and adapt to changing priorities
  • Ability to work independently and collaboratively
  • Self-starter mentality with resourceful problem-solving skills and a drive to meet targets

Preferred Qualifications:
  • Associate degree (or higher) in a subject like accounting, mathematics, education, marketing, or business - education is weighted more than experience!
  • Accounting, bookkeeping, payroll, financial analysis, or premium audit experience
  • Experience as a loan officer or office manager

Compensation & Schedule:
Pay: $42,000-$55,000 annually
Schedule: Full-time options, Monday through Friday from 8 am-5 pm or 7 am-4 pm
Benefits:
  • Health, dental, and vision insurance
  • PTO
  • Flexible schedule
  • Growth opportunities
  • HSA/FSA
  • Life insurance
  • Short- and long-term disability
  • 401(k)
  • Laptop

Apply today for this Field Insurance Auditor role through our streamlined application. It's straightforward, efficient, and only takes a few minutes to get started on a career you can be proud of.
Must have the ability to pass a background check and drug screening test.

Apply