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Medical Claims Auditor Jobs (NOW HIRING)

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Medical Claims Quality Auditor $25/hr | Houston Heights Area | Full-Time | Contract to Hire Join a leading healthcare services organization that specializes in medical claims dispute resolution and ...

Claims Auditor

Sherman Oaks, CA · Remote

$24 - $28/hr

Audit medical claims for accuracy, completeness, and compliance with payer guidelines and ... auditing, claims processing, or healthcare billing * Strong knowledge of ICD-10, CPT, and HCPCS ...

Medical, Dental, Vision, Pharmacy, Life, & Disability * 401K- Matching * FSA * Employee Assistance ... Minimum of 2 years of experience as a Claims Auditor. * Excellent reading, verbal and written ...

Pharmacy auditing, medical billing auditing, or pharmacy technician experience is strongly preferred. Supervision The Claims Auditor will report directly to the Compliance Manager. * This is a ...

Claims Auditor

San Antonio, TX · On-site

$19.55 - $29.75/hr

POSITION SUMMARY/RESPONSIBILITIES Responsible for development and maintenance of claims auditing ... Minimum of five years experience in insurance, medical or managed care environment including two ...

POSITION SUMMARY/RESPONSIBILITIES Responsible for development and maintenance of claims auditing ... Minimum of five years experience in insurance, medical or managed care environment including two ...

POSITION SUMMARY/RESPONSIBILITIES Responsible for development and maintenance of claims auditing ... Minimum of five years experience in insurance, medical or managed care environment including two ...

Claims Auditor

San Antonio, TX · On-site

$19.55 - $29.75/hr

POSITION SUMMARY/RESPONSIBILITIES Responsible for development and maintenance of claims auditing ... Minimum of five years experience in insurance, medical or managed care environment including two ...

Claims Auditor

San Antonio, TX · On-site

$19.55 - $29.75/hr

POSITION SUMMARY/RESPONSIBILITIES Responsible for development and maintenance of claims auditing ... Minimum of five years experience in insurance, medical or managed care environment including two ...

Claims Auditor

San Antonio, TX · On-site

$19.55 - $29.75/hr

POSITION SUMMARY/RESPONSIBILITIES Responsible for development and maintenance of claims auditing ... Minimum of five years experience in insurance, medical or managed care environment including two ...

Affordable Medical/Dental/Vision insurance options * Generous paid time-off program and paid ... Proficient in processing/auditing claims for Medicare and Medicaid plans * Strong knowledge of CMS ...

Affordable Medical/Dental/Vision insurance options * Generous paid time-off program and paid ... Proficient in processing/auditing claims for Medicare and Medicaid plans * Strong knowledge of CMS ...

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Medical Claims Auditor information

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How much do medical claims auditor jobs pay per hour?

As of Sep 4, 2026, the average hourly pay for medical claims auditor in the United States is $25.61, according to ZipRecruiter salary data. Most workers in this role earn between $17.79 and $24.52 per hour, depending on experience, location, and employer.

What does a medical claims auditor do?

A Medical Claims Auditor is responsible for reviewing and evaluating healthcare claims to ensure accuracy, compliance with regulations, and proper billing practices. They analyze medical records, billing codes, and insurance policies to detect errors, fraud, or overpayments. Their work helps healthcare providers and insurance companies maintain financial integrity and meet legal standards. Medical Claims Auditors often collaborate with medical staff, coders, and insurance representatives to resolve discrepancies and improve processes.

What are the key skills and qualifications needed to thrive as a medical claims auditor?

To thrive as a Medical Claims Auditor, you need a solid understanding of medical billing, coding standards (such as ICD-10 and CPT), and healthcare regulations, often supported by a degree in health information management or a related field. Familiarity with claims processing software, electronic health records (EHRs), and relevant certifications like Certified Professional Medical Auditor (CPMA) are typically required. Attention to detail, analytical thinking, and strong communication skills help auditors identify discrepancies and collaborate effectively with providers and insurers. These competencies are crucial to ensure accurate claims processing, reduce fraud, and maintain compliance with healthcare regulations.

What are some common challenges faced by medical claims auditors and how are they typically addressed?

Medical Claims Auditors often encounter challenges such as interpreting complex medical records, staying updated with ever-changing healthcare regulations, and identifying errors or fraud within large volumes of claims data. To address these challenges, auditors rely on continual professional development, robust auditing software, and close collaboration with billing departments and medical staff. Working as part of a team, they frequently hold review meetings to discuss ambiguous cases and share insights on best practices, ensuring accuracy and compliance across all audits.

What is the difference between Medical Claims Auditor vs Medical Billing Specialist?

AspectMedical Claims AuditorMedical Billing Specialist
CredentialsCertification (e.g., CPC, CCA), relevant experienceCertification (e.g., CPC), relevant experience
Work EnvironmentInsurance companies, healthcare facilities, auditing firmsMedical offices, billing companies, healthcare providers
Job FocusReviewing and verifying insurance claims for accuracy and compliancePreparing and submitting insurance claims, patient billing

Medical Claims Auditors focus on reviewing and verifying insurance claims for accuracy, ensuring compliance with policies. Medical Billing Specialists handle the preparation and submission of claims and patient billing. While both roles require similar certifications and work in healthcare settings, their primary responsibilities differ: auditing versus billing.

More about Medical Claims Auditor jobs

What cities are hiring for Medical Claims Auditor jobs?

Cities with the most Medical Claims Auditor job openings:

Who are the top companies hiring for Medical Claims Auditor jobs?

The top employers for Medical Claims Auditor jobs are:

What states have the most Medical Claims Auditor jobs?

States with the most job openings for Medical Claims Auditor jobs include:

Infographic showing various Medical Claims Auditor job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 15% Part Time, and 6% Contract. Highlights an 92% Physical, 1% Hybrid, and 7% Remote job distribution, with an average salary of $53,259 per year, or $25.6 per hour.

Medical Claims Quality Auditor

RemX

Houston, TX • On-site

$25/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 17 days ago

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Job description

Medical Claims Quality Auditor

$25/hr | Houston Heights Area | Full-Time | Contract to Hire

Join a leading healthcare services organization that specializes in medical claims dispute resolution and arbitration support. We're seeking detail-oriented professionals with experience in medical billing, coding, claims review, or legal/paralegal work.

Schedule: Monday-Friday, 8:00 AM-5:00 PM
Location: Houston Heights area (77018)  -100% onsite

What You'll Do:

  • Audit arbitration and dispute resolution decisions for accuracy and regulatory compliance
  • Analyze trends and track performance metrics
  • Communicate with arbitrators and provide supporting documentation
  • Submit final determinations through internal systems
  • Ensure quality standards and deadlines are consistently met

What We're Looking For:

  • Experience with medical billing, coding, claims auditing, or healthcare administration
  • Understanding of dispute resolution or arbitration processes preferred
  • Strong attention to detail and communication skills
  • Medical coding or paralegal experience is a plus

Important: Candidates should live within approximately 30 minutes of the Houston Heights area due to traffic and the fully onsite schedule.


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About RemX

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RemX is a proven leader in the Contract to Hire job industry. We help place the right people in the right jobs. Let us help you today!

Industry

Recruiting and staffing services

Company size

501 - 1,000 Employees

Headquarters location

Atlanta, GA, US

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