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Health Insurance Auditor Jobs (NOW HIRING)

State of South Dakota

Legislative Auditor

Brookings, SD · On-site

$63K - $66K/yr

Job ID: 35204 - Legislative Auditor Agency: Department of Legislative Audit Location: Brookings ... Health Insurance ($0 employee-only premium option) * Well-Being Program * Employee Assistance ...

Gem

Auditor

Brooklyn, NY · On-site

$22/hr

Auditor Location: HQ Schedule: Full-Time Pay Range: $22 per hour Hours: Mon-Fri; 9:30 am - 6:00 pm ... Health insurance * Paid time off Responsibilities: · Conduct regular audits of Hardgoods (HG ...

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Relevante, Inc.

Senior Auditor

Orlando, FL · On-site

$75K - $92K/yr

Benefits for the Senior Auditor ... Health Insurance * Dental Insurance * Profit Sharing About Relevante, Inc. - the Recruiting Firm ...

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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
Legislative Auditor

Legislative Auditor

State of South Dakota

Brookings, SD • On-site

$63K - $66K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 10 days ago

State Of South Dakota rating

6.9

Company rating: 6.9 out of 10

Based on 50 frontline employees who took The Breakroom Quiz

41st of 50 rated states

Job description

Job ID: 35204 - Legislative Auditor
Agency: Department of Legislative Audit
Location: Brookings, Madison, Dell Rapids and DeSmet
Salary: $63,000-$66,000 annually, depending on experience and qualifications
Closing Date: Open Until Filled
This is a Full-Time 40 Hour Weekly position with the Department of Legislative Audit. For more information on the Department of Legislative Audit, please visithttps://legislativeaudit.sd.gov.
Are you looking to take your career to the next level? If so, explore a career with the Department of Legislative Audit.
Legislative Audit is looking for a motivated and skilled individual to perform audits of various local government entities (Counties, Cities, Schools).
With Legislative Audit, you would be a part of a group of professionals that are dependable, focused on details, motivated, and recognized for our integrity and high-quality work.
Legislative Audit is a non-partisan agency which is responsible for auditing state and local governmental entities and oversight of state government. Legislative Audit strives to deliver on our mission to make government work better. We believe our success as an agency depends on finding opportunities for employees to accomplish our agency's goals and answer challenges to make things better.
We want every member of our team of professionals to be excited to come to work every day and be challenged. Through dedicated hard work and commitment, every Legislative Audit employee accepts personal responsibility to accomplish and uphold our mission.
Major responsibilities will include:
  • Work well individually and in a team environment.
  • Produce neat, concise, logical, and well-supported work product that comply with auditing standards and best practices.
  • Contribute to a results-oriented culture through active participation in meetings and collaboration with coworkers.
  • Ensure that written and verbal communications are clear and easily understood by all clients, such as the legislature, state agencies, local governing bodies, elected officials, the citizens of the State of South Dakota and the federal government.
  • Show initiative and seek opportunities for innovation and increased efficiency to improve and support the mission to make government work better.

Qualifications:
Graduation from an accredited college or university with a bachelor's degree in Accounting or Business Administration. Other combinations of education and experience, if evaluated as equivalent, may qualify an applicant for consideration.
Candidatesare notrequired to be a licensed Certified Public Accountant (CPA) for employment. We do encourage, and assist, our professionals in obtaining further certifications, such as a Certified Public Accountant (CPA), Certified Fraud Examiner (CFE), Certified Internal Auditor (CIA), Certified Information Systems Auditor (CISA), Certified Investments and Derivatives Auditor (CIDA) and other professional certifications.
Knowledge of the following would be beneficial:
  • Microsoft Excel, Word, and other desktop tools
  • Governmental Accounting
  • Generally Accepted Accounting Principles (GAAP)
  • Generally Accepted Auditing Standards (GAAS) and Governmental Auditing Standards

Benefits beyond the paycheck:
  • Vacation Leave (15 days per year)
  • Sick Leave (14 days per year)
  • Paid Family Leave (up to twelve weeks of additional leave due to birth or adoption of a child)
  • 11 Paid Holidays
  • Health Insurance ($0 employee-only premium option)
  • Well-Being Program
  • Employee Assistance Program
  • Dental Insurance
  • Vision Insurance
  • Health Savings Account
  • Basic Life Insurance Coverage (free to employees)
  • Membership in the South Dakota Retirement System (a top-rated public retirement system)
  • Longevity Pay
  • Semimonthly Pay Periods

Additional Requirements: To be considered, attach your cover letter, resume, and college transcript with application.
This position is exempt from the Civil Service Act.
The State of South Dakota does not sponsor work visas for new or existing employees. All persons hired will be required to verify identity and eligibility to work in the United States and complete an Employment Eligibility Verification, Form I-9. The State of South Dakota as an employer will be using E-Verify to complete employment eligibility verification upon hire.
The State of South Dakota offers $0 premium employee health insurance option plus eleven paid holidays, generous vacation and sick leave accrual, dental, vision, and other insurance options, and retirement benefits. You can view our benefits information here. This position is a member of Class A retirement under SDRS.
Must apply online: https://gen-stateofsouthdako-trn.inforcloudsuite.com/hcm/xmlhttp/shorturl.do?key=3PZ
You must apply online, emailed resumes or submissions will not be accepted.
South Dakota Bureau of Human Resources
Telephone: 605.773.3148 Email: careers@state.sd.us
http://bhr.sd.gov/workforus
"An Equal Opportunity Employer"

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