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Managed Care Auditor Jobs in Riverside, CA (NOW HIRING)

RIS Rx

Be Seen First

Pharmacy Auditor

Irvine, CA · On-site

$21 - $25/hr

Program Supervisor/Solutions Manager FLSA Status: Non-Exempt About Our Organization: RIS Rx ... Bachelor's degree in healthcare administration, pharmacy, or related field preferred * Extensive ...

Prime Healthcare

OP Coder Auditor Trainee

Ontario, CA · On-site

$26.04 - $32.37/hr

Prime Healthcare is an award-winning health system headquartered in Ontario, California. Prime ... hospital management staff. * Ability to work independently in a time-oriented environment.

Inland Regional Center

Auditor 1

San Bernardino, CA · Hybrid

SUMMARY: Under direction of the Admin Unit Manager - Accounting & Audit, participate in on-site ... Review vendor payroll records to determine if there are sufficient direct care staff at the vendor ...

Hotel Fera Anaheim

Night Auditor

Orange, CA · On-site

$21/hr

SPIRE Hospitality is a management company specializing in creating memorable guest experiences and ... Deliver unparalleled service, courtesy, and care to our guests by responding promptly and ...

Jobs for Humanity

Sr. Internal Auditor

Tustin, CA · On-site +1

$88K - $110K/yr

... dental care. Our culture emphasizes collaboration, integrity, and accountability-and our People ... Ability to work independently while managing multiple priorities * Strong written and verbal ...

Avanath

Compliance Auditor

Irvine, CA · On-site

Overview Avanath is proud to be named one of the top property management companies to provide ... laws, Affordable Care Act regulations, and internal policies. This role involves carefully ...

Avanath

Compliance Auditor

Irvine, CA · On-site

Overview Avanath is proud to be named one of the top property management companies to provide ... laws, Affordable Care Act regulations, and internal policies. This role involves carefully ...

Avanath

Compliance Auditor

Irvine, CA

Overview Avanath is proud to be named one of the top property management companies to provide ... laws, Affordable Care Act regulations, and internal policies. This role involves carefully ...

Prime Healthcare Management Inc

Coder Auditor

Ontario, CA · On-site

$28 - $43.40/hr

Prime Healthcare operates 54 hospitals and has more than 360 outpatient locations in 15 states ... Responsibilities The Inpatient Coder Auditor reviews and analyzes documentation present in the ...

Spire Hospitality

Night Auditor

Orange, CA · On-site

$21/hr

SPIRE Hospitality is a management company specializing in creating memorable guest experiences and ... Deliver unparalleled service, courtesy, and care to our guests by responding promptly and ...

Alignment Healthcare

Sr. Tax Analyst

Orange, CA · On-site

$123K - $124K/yr

... auditors and tax advisors with documentation and technical analysis Preferred * Located in Orange County, CA as role is Hybrid as needed * Prior experience in the healthcare, managed care, or ...

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Showing results 21-40

All JobsManaged Care Auditor JobsManaged Care Auditor Jobs in Riverside, CA

Managed Care Auditor information

See Riverside, CA salary details

$10

$20

$48

How much do managed care auditor jobs pay per hour?

As of Sep 7, 2026, the average hourly pay for managed care auditor in Riverside, CA is $20.04, according to ZipRecruiter salary data. Most workers in this role earn between $15.05 and $20.05 per hour, depending on experience, location, and employer.

What is a managed care auditor?

A Managed Care Auditor is a professional who reviews and evaluates healthcare claims, billing records, and contracts to ensure compliance with managed care agreements and regulatory requirements. They work for insurance companies, healthcare providers, or third-party organizations to identify errors, prevent fraud, and ensure that reimbursements are accurate. Managed Care Auditors help organizations optimize their processes, reduce costs, and maintain compliance with healthcare laws and policies. Their work plays a crucial role in safeguarding the financial integrity of managed care programs.

What are the key skills and qualifications needed to thrive as a managed care auditor?

To thrive as a Managed Care Auditor, you need in-depth knowledge of healthcare compliance, claims auditing, and managed care regulations, often supported by a degree in healthcare administration or a related field. Familiarity with claims processing systems, medical coding software (such as ICD-10 and CPT), and audit management tools is typically required, with certifications like Certified Professional Medical Auditor (CPMA) being advantageous. Attention to detail, analytical thinking, and strong communication skills help auditors identify discrepancies and collaborate with stakeholders. These skills are crucial for ensuring healthcare providers and payers adhere to regulatory standards and optimize financial performance.

What are some common challenges faced by managed care auditors when working with healthcare providers and payers?

Managed Care Auditors often encounter challenges such as navigating complex contract terms, interpreting varying payer requirements, and keeping up with frequent regulatory changes. Coordinating with healthcare providers and insurance companies can also be demanding, as it requires strong communication and negotiation skills to resolve discrepancies. Additionally, Managed Care Auditors must maintain accuracy and attention to detail while analyzing large volumes of medical and financial data, all within tight deadlines.

What is the difference between Managed Care Auditor vs Claims Reviewer?

AspectManaged Care AuditorClaims Reviewer
Required CredentialsCertifications like CHC, CPC, or relevant healthcare auditing credentialsOften CPC, CCS, or claims processing certifications
Work EnvironmentHealthcare organizations, insurance companies, government agenciesInsurance companies, healthcare providers, third-party administrators
Employer & Industry UsageUsed in managed care plans, health insurance, and healthcare complianceCommon in insurance claims processing and reimbursement review

While both roles involve reviewing healthcare-related documents, Managed Care Auditors focus on evaluating the accuracy and compliance of managed care plans, whereas Claims Reviewers primarily assess individual insurance claims for correctness and eligibility. The roles often overlap in credentials and work environments but differ in scope and focus within the healthcare reimbursement process.

What are popular job titles related to Managed Care Auditor jobs in Riverside, CA?

For Managed Care Auditor jobs in Riverside, CA, the most frequently searched job titles are:

What job categories do people searching Managed Care Auditor jobs in Riverside, CA look for?

The top searched job categories for Managed Care Auditor jobs in Riverside, CA are:

What cities near Riverside, CA are hiring for Managed Care Auditor jobs?

Cities near Riverside, CA with the most Managed Care Auditor job openings:

Managed Care Auditor jobs near you
Infographic showing various Managed Care Auditor job openings in Riverside, CA as of August 2026, with employment types broken down into 2% As Needed, 71% Full Time, 20% Part Time, and 7% Contract. Highlights an 93% Physical, 1% Hybrid, and 6% Remote job distribution, with an average salary of $41,675 per year, or $20 per hour.

OP Coder Auditor Trainee

Prime Healthcare Management Inc

Ontario, CA • On-site

$26.04 - $32.37/hr

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 4 days ago

Key responsibilities

  • Review and analyze documentation in medical records for outpatient visits to ensure accuracy of diagnosis and procedure codes.

  • Finalize coding and abstracting of medical records, ensuring correct assignment of ICD, CPT, and HCPCS codes supported by clinical documentation.

  • Assist in DRG validation/accuracy and support clinical documentation improvement efforts.

Prime Healthcare rating

6.4

Company rating: 6.4 out of 10

Based on 289 frontline employees who took The Breakroom Quiz

648th of 898 rated healthcare providers

Job description

Overview

Prime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 54 hospitals and has more than 360 outpatient locations in 15 states providing more than 3.0million patient visits annually. It is one of the nation's leading health systems with over 60,000 employees and physicians. Twenty-one of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation, a 501(c)(3) not-for-profit public charity. Prime Healthcare is actively seeking new members to join our corporate team!

Responsibilities

The Outpatient Coder Auditor Trainee reviews and analyzes documentation present in the medical record for outpatient visits to ensure accuracy of diagnosis and procedure codes assigned by the Coders or Clinical Documentation Specialists (CDS) or Computer Assisted Coding (CAC) software. The Outpatient Coder Auditor Trainee finalizes the coding and abstracting of the medical record upon ensuring the assignment of International Classifications of Diseases, Ninth Revision (ICD-9-CM) or Tenth revision (ICD-10/PCS), Current Procedural Terminology (CPT), and Health Care Procedure Coding System (HCPCS), are accurate and supported by the clinical documentation of the respective medial record. Holding a senior coding position, assumes primary responsibility for DRG validation/accuracy, primary role in assisting CDS and medical staff members with improving quality of clinical documentation. Participates in chart review projects as assigned and other duties as needed.

Qualifications

Education and Work Experience

Required qualifications:

  • Medical Graduate, PA or Nursing Graduate required.
  • Basic computer experience required.
  • Use of an encoder software product for code assignment in an acute care setting required

    • Preferred qualifications:

  • Computer data entry with 10-key preferred, with accurate typing speed of 35 wpm preferred.
  • Excellent written and verbal communication skills. Excellent critical thinking skills.
  • Excellent interpersonal skills to build effective partnering relationships with physicians, nurse staff, coding staff and hospital management staff.
  • Ability to work independently in a time-oriented environment.
  • Computer literacy and familiarity with the operation of basic office equipment.
  • 1+ year of clinical experience in acute care setting preferred.
    • Pay Transparency

    Prime Healthcare offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options. A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $26.04 to $32.37. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.

    Employment StatusFull TimeShiftDaysEqual Employment Opportunity

    Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf

     Privacy Notice

    Privacy Notice for California Applicants: https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf

    Employment Type: FULL_TIME

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