You Are UST HealthProof is looking for an Enrollment Quality Auditor with health plan Medicaid ... Provide inputs to the Training team and Team Leads for up-to-date written processing instructions ...
You Are UST HealthProof is looking for an Enrollment Quality Auditor with health plan Medicaid ... Provide inputs to the Training team and Team Leads for up-to-date written processing instructions ...
You Are UST HealthProof is looking for an Enrollment Quality Auditor with health plan Medicaid ... Provide inputs to the Training team and Team Leads for up-to-date written processing instructions ...
You Are UST HealthProof is looking for an Enrollment Quality Auditor with health plan Medicaid ... Provide inputs to the Training team and Team Leads for up-to-date written processing instructions ...
You Are UST HealthProof is looking for an Enrollment Quality Auditor with health plan Medicaid ... Provide inputs to the Training team and Team Leads for up-to-date written processing instructions ...
You Are UST HealthProof is looking for an Enrollment Quality Auditor with health plan Medicaid ... Provide inputs to the Training team and Team Leads for up-to-date written processing instructions ...
... and Enrollment Quality Auditors supporting Medicaid managed care, managed long-term care (MLTC ... The Lead will oversee calibration efforts, provide coaching to auditors, and deliver actionable ...
... and Enrollment Quality Auditors supporting Medicaid managed care, managed long-term care (MLTC ... The Lead will oversee calibration efforts, provide coaching to auditors, and deliver actionable ...
System Auditing & Support: Supporting audits of enrollment applications, remediating data quality issues, and assisting with data mapping or provider enrollment system updates. * Relationship ...
System Auditing & Support: Supporting audits of enrollment applications, remediating data quality issues, and assisting with data mapping or provider enrollment system updates. * Relationship ...
Quality Auditor
$21.75 - $23/hr
Quality Auditor We are dedicated to maintaining the highest standards of quality in our processes ... and providing actionable recommendations to enhance quality performance. - Assisting in the ...
Quick apply
Quality Auditor
$21.75 - $23/hr
Quality Auditor We are dedicated to maintaining the highest standards of quality in our processes ... and providing actionable recommendations to enhance quality performance. - Assisting in the ...
Quality Auditor We are dedicated to maintaining the highest standards of quality in our processes ... and providing actionable recommendations to enhance quality performance. - Assisting in the ...
Quick apply
Quality Auditor We are dedicated to maintaining the highest standards of quality in our processes ... and providing actionable recommendations to enhance quality performance. - Assisting in the ...
Experience with provider enrollment auditing and quality assurance * Proficiency in Microsoft Word, Excel, Outlook, PDF Software and other management tools. * Motivated to quickly learn and ...
Experience with provider enrollment auditing and quality assurance * Proficiency in Microsoft Word, Excel, Outlook, PDF Software and other management tools. * Motivated to quickly learn and ...
Quality Auditor
Olive Branch, MS · On-site
Quality Auditor 2nd shift Monday- Thursday 5:00 PM 3:00 AM At Milwaukee Tool we firmly believe that ... provide.... Behind our doors you'll be empowered every day to own it, drive it, and do what it ...
Quality Auditor
Olive Branch, MS · On-site
Quality Auditor 2nd shift Monday- Thursday 5:00 PM 3:00 AM At Milwaukee Tool we firmly believe that ... provide.... Behind our doors you'll be empowered every day to own it, drive it, and do what it ...
Quality Auditor
Mossville, IL · On-site
$21/hr
... providing operational Quality Management solutions for the manufacturing sector, especially in the ... to expert auditing, consulting and training.The unrivaled expertise, industrial mindset and ...
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Quality Auditor
Mossville, IL · On-site
$21/hr
... providing operational Quality Management solutions for the manufacturing sector, especially in the ... to expert auditing, consulting and training.The unrivaled expertise, industrial mindset and ...
Be Seen First
Quality Auditor
Alsip, IL · On-site
$18.50/hr
As a Quality Auditor, you will ensure that manufactured goods meet customer requirements and ... the leader in providing industrial temporary help. We pride ourselves on taking care of our ...
Quick apply
Be Seen First
Quality Auditor
Alsip, IL · On-site
$18.50/hr
As a Quality Auditor, you will ensure that manufactured goods meet customer requirements and ... the leader in providing industrial temporary help. We pride ourselves on taking care of our ...
Provider Enrollment Specialist
$22 - $26/hr
Experience with provider enrollment auditing and quality assurance * Proficiency in Microsoft Word, Excel, Outlook, PDF Software and other management tools. * Motivated to quickly learn and ...
Provider Enrollment Specialist
$22 - $26/hr
Experience with provider enrollment auditing and quality assurance * Proficiency in Microsoft Word, Excel, Outlook, PDF Software and other management tools. * Motivated to quickly learn and ...
Quality Auditor
Mossville, IL · On-site
$20/hr
... providing operational Quality Management solutions for the manufacturing sector, especially in the ... to expert auditing, consulting and training.The unrivaled expertise, industrial mindset and ...
Quality Auditor
Mossville, IL · On-site
$20/hr
... providing operational Quality Management solutions for the manufacturing sector, especially in the ... to expert auditing, consulting and training.The unrivaled expertise, industrial mindset and ...
Quality Auditor
Olive Branch, MS · On-site
Quality Auditor 2nd shift Monday- Thursday 5:00 PM 3:00 AM At Milwaukee Tool we firmly believe that ... provide.... Behind our doors you'll be empowered every day to own it, drive it, and do what it ...
Quality Auditor
Olive Branch, MS · On-site
Quality Auditor 2nd shift Monday- Thursday 5:00 PM 3:00 AM At Milwaukee Tool we firmly believe that ... provide.... Behind our doors you'll be empowered every day to own it, drive it, and do what it ...
Quality Auditor
Champaign, IL · On-site
$18 - $19/hr
... providing operational Quality Management solutions for the manufacturing sector, especially in the ... to expert auditing, consulting and training.The unrivaled expertise, industrial mindset and ...
Quick apply
Quality Auditor
Champaign, IL · On-site
$18 - $19/hr
... providing operational Quality Management solutions for the manufacturing sector, especially in the ... to expert auditing, consulting and training.The unrivaled expertise, industrial mindset and ...
Quality Auditor
Champaign, IL · On-site
$19/hr
... providing operational Quality Management solutions for the manufacturing sector, especially in the ... to expert auditing, consulting and training.The unrivaled expertise, industrial mindset and ...
Quality Auditor
Champaign, IL · On-site
$19/hr
... providing operational Quality Management solutions for the manufacturing sector, especially in the ... to expert auditing, consulting and training.The unrivaled expertise, industrial mindset and ...
Quality Auditor
Alsip, IL · On-site
As a Quality Auditor, you will ensure that manufactured goods meet customer requirements and ... Company Description Ron's Staffing Services, Inc. is the leader in providing industrial temporary ...
Quality Auditor
Alsip, IL · On-site
As a Quality Auditor, you will ensure that manufactured goods meet customer requirements and ... Company Description Ron's Staffing Services, Inc. is the leader in providing industrial temporary ...
Quality Auditor
West Columbia, SC · On-site
$21 - $22/hr
Quality Auditor Location: West Columbia, SC Hire Type: Contract to Hire Shift: Mon-Fri 7a -3:30p ... Provide immediate feedback to production teams regarding process deviations or nonconformances.
Quick apply
Quality Auditor
West Columbia, SC · On-site
$21 - $22/hr
Quality Auditor Location: West Columbia, SC Hire Type: Contract to Hire Shift: Mon-Fri 7a -3:30p ... Provide immediate feedback to production teams regarding process deviations or nonconformances.
Experience with provider enrollment auditing and quality assurance * Proficiency in Microsoft Word, Excel, Outlook, PDF Software and other management tools. * Motivated to quickly learn and ...
Experience with provider enrollment auditing and quality assurance * Proficiency in Microsoft Word, Excel, Outlook, PDF Software and other management tools. * Motivated to quickly learn and ...
The Quality Auditor provides technical guidance to the Quality Assurance team, within a business unit. Responsible for developing, implementing and auditing QMS processes. Collaborates with other ...
The Quality Auditor provides technical guidance to the Quality Assurance team, within a business unit. Responsible for developing, implementing and auditing QMS processes. Collaborates with other ...
Provider Enrollment Quality Auditor information
See salary details
$17.24 is the 25th percentile. Wages below this are outliers.
$12.74 - $24.61
66% of jobs
$30.71 is the 75th percentile. Wages above this are outliers.
$24.61 - $36.47
18% of jobs
$36.47 - $48.34
6% of jobs
$48.34 - $60.21
2% of jobs
$60.21 - $72.07
1% of jobs
$72.07 - $83.94
0% of jobs
$83.94 - $95.80
0% of jobs
$95.80 - $107.67
0% of jobs
$107.67 - $119.54
0% of jobs
$119.54 - $131.40
3% of jobs
$131.40 - $143.27
4% of jobs
$12
$38
$143
How much do provider enrollment quality auditor jobs pay per hour?
As of Sep 14, 2026, the average hourly pay for provider enrollment quality auditor in the United States is $38.60, according to ZipRecruiter salary data. Most workers in this role earn between $17.31 and $32.69 per hour, depending on experience, location, and employer.
What are popular job titles related to Provider Enrollment Quality Auditor jobs?
For Provider Enrollment Quality Auditor jobs, the most frequently searched job titles are:
Enrollment Quality Auditor
Remote
HealthEdge
• Computer and Computer Peripheral Equipment and Software Wholesalers • 201 - 500 employees201 - 500 employees
Full-time
Posted 4 days ago
Job description
Overview
HealthEdge® offers AI-powered operational infrastructure for health insurance companies, guaranteeing an enduring financial edge in an increasingly competitive market. We're experiencing strong market momentum, with a growing number of health plans choosing HealthEdge to modernize their operations and compete more effectively. As we expand, we're investing in the people who power that growth, making this a pivotal moment to join us and shape the future of healthcare technology. Learn more at HealthEdge.com.
UST HealthProof is a trusted partner for health plans, offering an integrated ecosystem for health plan operations that helps our customers achieve affordable, equitable health care for all. We have a strong global presence, with a workforce of over 4,000 people built on a foundation of simplicity, integrity, people-centricity, and leadership.
You Are
UST HealthProof is looking for an Enrollment Quality Auditor with health plan Medicaid member enrollment and eligibility operations experience. This role will report to the Lead Auditor or Quality Audit Manager. The Quality Auditor performs audits of an assigned group of enrollment transactions (new enrollment, disenrollment, eligibility redeterminations, PCP and plan changes, retroactive enrollment actions) and will interact with the client audit team and operational managers daily to report on audit findings, which have an impact on production and quality. This role requires the ability to work both independently with limited supervision and collaboratively in a team environment.
The Opportunity
Perform audits of enrollment, disenrollment, eligibility, and plan/PCP change transactions processed by health plan enrollment associates for a specific customer.
What You Need
Geographic Responsibility: Remote, US
Type of Employment: Full-time, permanent
Work Environment: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job:
The above statements are intended to describe the general nature and level of the job being performed by the individual(s) assigned to this position. They are not intended to be an exhaustive list of all duties, responsibilities, and skills required. HealthEdge reserves the right to modify, add, or remove duties and to assign other duties as necessary. In addition, reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position in compliance with the Americans with Disabilities Act of 1990. Candidates may be required to go through a pre-employment criminal background check.
HealthEdge is an equal opportunity employer. We are committed to workforce diversity and actively encourage all qualified persons to seek employment with us, including, but not limited to, racial and ethnic minorities, women, veterans and persons with disabilities.
#LI-Remote
**The annual US base salary range for this position is $44,000 to $50,000. This salary range may cover multiple career levels at HealthEdge. Final compensation will be determined during the interview process and is based on a combination of factors including, but not limited to, your skills, experience, qualifications and education.
HealthEdge® offers AI-powered operational infrastructure for health insurance companies, guaranteeing an enduring financial edge in an increasingly competitive market. We're experiencing strong market momentum, with a growing number of health plans choosing HealthEdge to modernize their operations and compete more effectively. As we expand, we're investing in the people who power that growth, making this a pivotal moment to join us and shape the future of healthcare technology. Learn more at HealthEdge.com.
UST HealthProof is a trusted partner for health plans, offering an integrated ecosystem for health plan operations that helps our customers achieve affordable, equitable health care for all. We have a strong global presence, with a workforce of over 4,000 people built on a foundation of simplicity, integrity, people-centricity, and leadership.
You Are
UST HealthProof is looking for an Enrollment Quality Auditor with health plan Medicaid member enrollment and eligibility operations experience. This role will report to the Lead Auditor or Quality Audit Manager. The Quality Auditor performs audits of an assigned group of enrollment transactions (new enrollment, disenrollment, eligibility redeterminations, PCP and plan changes, retroactive enrollment actions) and will interact with the client audit team and operational managers daily to report on audit findings, which have an impact on production and quality. This role requires the ability to work both independently with limited supervision and collaboratively in a team environment.
The Opportunity
Perform audits of enrollment, disenrollment, eligibility, and plan/PCP change transactions processed by health plan enrollment associates for a specific customer.
- Be responsible for following the customer quality process and tools for audit and rebuttal process.
Review enrollment (834) file transactions and coordination with state enrollment systems and enrollment brokers to confirm accuracy of member effective dates, retroactive enrollment/disenrollment, and eligibility segments.
Verify timely and accurate processing of Medicaid eligibility redeterminations and recertifications against CMS and state Medicaid timeliness standards.
Audit dual-eligible (Medicare-Medicaid) enrollment coordination, including alignment of Medicare and Medicaid eligibility segments and coordination of benefits.
Share QA results with individual associates, coordinate with operational Team Leads and managers to provide feedback to individuals, clearly identifying errors and opportunities for improvement.
Collate, compile and report both team and individual associates' QA performance to management and individuals.
Provide inputs to the Training team and Team Leads for up-to-date written processing instructions and refresher training needs.
Participate in UST HealthProof's or the customer's Audit the Auditor program.
Participate in semi-annual or annual auditor calibration activities.
Maintain currency on CMS Medicaid managed care enrollment guidelines, applicable state Medicaid enrollment requirements, and managed long-term care (MLTC) enrollment/disenrollment rules.
What You Need
- High School Diploma or GED required.
- 3 years health plan enrollment/eligibility auditing operations experience required.
- Medicaid managed care enrollment auditing experience preferred; managed long-term care (MLTC) or dual-eligible (Medicare-Medicaid) enrollment experience strongly preferred.
- Proficiency in using MS Suite, specifically Excel, PowerPoint and Outlook.
- HealthRules® Payor or GuidingCare® experience preferred; familiarity with EDI 834 enrollment transactions and eligibility verification systems a plus.
- Ability to analyze contractual SLAs and KPIs, particularly around enrollment processing timeliness.
- Ability to effectively communicate and collaborate with a remote team.
Geographic Responsibility: Remote, US
Type of Employment: Full-time, permanent
Work Environment: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job:
- The employee is occasionally required to move around the office. Specific vision abilities required by this job include close vision, color vision, peripheral vision, depth perception, and ability to adjust focus.
- Work across multiple time zones in a hybrid or remote work environment.
- Long periods of time sitting and/or standing in front of a computer using video technology.
- May require travel dependent on company needs.
The above statements are intended to describe the general nature and level of the job being performed by the individual(s) assigned to this position. They are not intended to be an exhaustive list of all duties, responsibilities, and skills required. HealthEdge reserves the right to modify, add, or remove duties and to assign other duties as necessary. In addition, reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position in compliance with the Americans with Disabilities Act of 1990. Candidates may be required to go through a pre-employment criminal background check.
HealthEdge is an equal opportunity employer. We are committed to workforce diversity and actively encourage all qualified persons to seek employment with us, including, but not limited to, racial and ethnic minorities, women, veterans and persons with disabilities.
#LI-Remote
**The annual US base salary range for this position is $44,000 to $50,000. This salary range may cover multiple career levels at HealthEdge. Final compensation will be determined during the interview process and is based on a combination of factors including, but not limited to, your skills, experience, qualifications and education.
About HealthEdge
Sourced by ZipRecruiter
Health Edge ® provides modern, disruptive technology that delivers for the first time, a suite of products that enables healthcare payors to leverage new business models, improve outcomes, drastically reduce administrative costs and connect everyone in the healthcare delivery cycle. Our next-generation enterprise product suite, HealthRules ®, is built on modern, patented technology and is delivered to customers via the HealthEdge Cloud or on-site deployment. An award-winning company, HealthEdge empowers payors to capitalize on the innovations, challenges and opportunities that await in the new healthcare economy. For more information, visit .
Industry
Computer and computer peripheral equipment and software wholesalers
Company size
201 - 500 Employees
Headquarters location
Burlington, MA, US
Year founded
2005