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Health Insurance Auditor Jobs (NOW HIRING)

Suffolk County, NY

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 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.

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

Internal Auditor

Jack W Gooding Chapter 13 Standing

Little Rock, AR • On-site

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 20 days ago

Be an early applicant

Job description

Benefits:
  • 401(k)
  • Competitive salary
  • Dental insurance
  • Health insurance
  • Opportunity for advancement
  • Paid time off
  • Vision insurance

Chapter 13 Trustee Seeking Bankruptcy Claims Auditor: Role is full-time, in-office employment with excellent benefits. The role is responsible for auditing all aspects of secured and priority claims for completeness and accuracy. The Claims Auditor identifies and documents all exceptions, discrepancies, and errors. The Claims Auditor is responsible for identifying and communicating with staff attorneys regarding any objections to filed mortgage claims. The Claims Auditor is responsible for reconciling the trusteeship claims to the court claims docket and preparing a Summary Notice of Claims Filed. The Auditor must have a working knowledge of Windows software, Microsoft Excel, Outlook, and Word, the internet, and general computer experience. The ideal candidate must possess strong verbal and written communication skills, basic math skills, and accurate data-entry skills. The Auditor position requires a high degree of accuracy, attention to detail, and efficiency, as it involves significant data processing.