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Provider Auditor Jobs (NOW HIRING)

Mountain Area Health Education Center

The Provider Educator plays a key role in empowering our healthcare providers-physicians, residents ... Collaborates with our auditor to review audits, set up audit schedule and give feedback * Conducts ...

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Provider Auditor information

See salary details

$30.5K

$72.6K

$117.5K

How much do provider auditor jobs pay per year?

As of Sep 6, 2026, the average yearly pay for provider auditor in the United States is $72,633.00, according to ZipRecruiter salary data. Most workers in this role earn between $47,000.00 and $98,500.00 per year, depending on experience, location, and employer.

What is a provider auditor?

Provider Auditors are professionals who review and assess healthcare providers’ records, billing practices, and claims to ensure compliance with regulations and detect potential fraud or errors. They analyze medical documentation, verify the accuracy of billing codes, and ensure that services billed were actually provided and are medically necessary. Provider Auditors play a crucial role in maintaining the integrity of healthcare reimbursement systems and help organizations avoid penalties associated with improper billing.

What skills and qualifications are needed to be a provider auditor?

To thrive as a Provider Auditor, you need a solid understanding of healthcare billing, coding standards (such as ICD-10 and CPT), and auditing procedures, often supported by a degree in healthcare administration or a related field. Familiarity with claims management software, electronic health records (EHR) systems, and certifications like Certified Professional Medical Auditor (CPMA) are commonly required. Attention to detail, analytical thinking, and strong communication skills help you identify discrepancies and clearly relay findings to providers. These skills ensure accurate audits, regulatory compliance, and reduced financial risk for healthcare organizations.

What challenges do provider auditors face when evaluating healthcare claims, and how can they address them?

Provider Auditors often encounter challenges such as incomplete documentation, complex billing codes, and discrepancies between services billed and services rendered. To address these, auditors need to maintain strong attention to detail, stay updated on current regulations and coding standards, and communicate effectively with providers to clarify ambiguities. Building collaborative relationships with clinical staff and regularly participating in training sessions can also help auditors navigate these complexities and ensure compliance with healthcare policies.

What is the difference between Provider Auditor vs Claims Auditor?

AspectProvider AuditorClaims Auditor
CertificationsCPA, CPC, or healthcare-specific certificationsCPA, CPC, or healthcare-specific certifications
Work EnvironmentHealthcare facilities, insurance companies, or government agenciesInsurance companies, healthcare organizations, or third-party auditing firms
Primary FocusAuditing healthcare providers' billing, coding, and complianceReviewing insurance claims for accuracy and fraud detection

Provider Auditors primarily focus on evaluating healthcare providers' billing and compliance practices, ensuring adherence to regulations. Claims Auditors concentrate on reviewing insurance claims for accuracy, fraud, and proper reimbursement. While both roles require similar certifications and work in healthcare or insurance settings, their core responsibilities differ—Provider Auditors assess provider practices, whereas Claims Auditors scrutinize insurance claims.

More about Provider Auditor jobs

What job categories do people searching Provider Auditor jobs look for?

The top searched job categories for Provider Auditor jobs are:

Provider Auditor jobs near you
Infographic showing various Provider Auditor job openings in the United States as of August 2026, with employment types broken down into 1% Locum Tenens, 2% As Needed, 76% Full Time, 16% Part Time, and 5% Contract. Highlights an 94% Physical, 1% Hybrid, and 5% Remote job distribution, with an average salary of $72,633 per year, or $34.9 per hour.

Financial Services Auditor

Louisiana Legislative Auditor

Baton Rouge, LA • On-site

$83K/yr

Full-time

Re-posted 6 days ago

Job description

Overview
For more than 50 years, the LLA has helped the state of Louisiana foster accountability and transparency within Louisiana's government by providing the Legislature and others with audit services, fiscal advice, and other useful information.
Staff Auditor 1 has a minimum annual salary of $54,000.
Staff Auditor 2 has a minimum annual salary of $58,320.
Staff Auditor 3 has a minimum annual salary of $62,985.
Sr. Auditor 1 has a minimum annual salary of $76,000.
Sr. Auditor 2 has a minimum annual salary of $83,000.
The LLA is seeking individuals to fill vacancies in our Financial Audit Section. This individual should have a working knowledge of governmental accounting and auditing standards. In addition, a Financial Auditor should possess effective verbal and written communication skills and work effectively with the audit supervisor, auditee and team members.
As part of our career progression framework, vacancies may be filled from this recruitment as a Staff or Senior Auditor depending on the level of experience of the selected applicant.
Responsibilities
Examples listed below include brief samples of common duties associated with financial audits. Please note that not all tasks are included.
  • May conduct financial, operational, and/or compliance type audits for a state entity.
  • Assists in developing an audit project program and/or testing procedures.
  • Assists in preparing audit reports and follow up to determine if corrective action has been taken.
  • Performs financial audits by examining a variety of fiscal documents to ascertain the validity of information reported and the dependability of record keeping and reporting practices of an audited entity.
  • Performs operational audits by analyzing and testing to determine if operational effectiveness and efficiency are being achieved according to business unit strategic objectives, and evaluating the adequacy and effectiveness of process controls.
  • Performs compliance audits by testing to identify non-compliance with applicable laws, regulations, contractual obligations, or agency policies and procedures.
  • May perform special audit projects and investigations, as requested or required.
  • Uses effective sampling techniques during audits, as warranted.
  • Uses data processing information systems, software, and other automated tools to assist in performing audits.
  • Conducts inquiries of auditee personnel to gain an understanding of internal controls and is able to clearly document that understanding.
  • Obtains relevant audit evidence and makes a preliminary evaluation of that evidence to reach logical conclusions.
  • Identifies, assesses, and documents risks and demonstrates the ability to identify risks of material misstatement and risks of material noncompliance and/or indications of errors and irregularities or fraud and illegal acts during the conduct of the audit.

Other Duties & Responsibilities
The above statements are intended to describe the general nature and level of the work being performed by individuals assigned to this position. They are not an exhaustive list of all duties and responsibilities associated with it. The absence of specific statements of duties does not exclude those tasks from the position if the work is similar, related to, or a logical assignment for the position.
Qualifications
  • A baccalaureate degree from an accredited college or university (in any major), meeting the eligibility requirements to take the Certified Public Accountant examination in Louisiana, OR
  • Possess certification as a Certified Public Accountant.

Please visit our career site at www.llajobs.com or apply directly for this position by creating a profile and uploading the following information to https://careers-llajobs.icims.com/jobs/intro:
  • Resume
  • Cover letter
  • Official or Unofficial College transcripts

Apply