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Remote Medical Claim Auditor Jobs (NOW HIRING)

Vytwo

SW Engineer (DevOps)

Prosper, TX · Remote

$48.25 - $66.25/hr

... our legacy claim auditing system. Youll analyze the needs and the environment to make sure the ... This is a remote position.

Humana, Inc.

Inpatient Medical Coding Auditor

Humana, a Fortune 100 Company, is looking for an experienced, Remote medical coding auditor to ... The goal is to ensure the accuracy and integrity of hospital claim payments. Responsibilities ...

RemX

Be Seen First

Remote Medical Claims Specialist- $26/Hr.

Cleveland, OH · Remote

$26/hr

Remote Medical Claims Specialist- $26/Hr. Temp to Hire 100% Remote | Full-Time | M-F | 8AM-5PM CST ... Review, analyze, and resolve claim issues without relying on automated system prompts * Apply ...

RemX

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Fully Remote Medical Claims Rep- $26/Hr.

Charlotte, NC · Remote

$26/hr

Remote Medical Claims Billing Coordinator (Contract-to-Hire) 100% Remote | Full-Time | M-F | 8AM ... Review, analyze, and resolve claim issues without relying on automated system prompts * Apply ...

Lancesoft - Viren

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Healthcare - Medical Claim Review Nurse

Florida City, FL · Remote

$40.39 - $43.39/hr

Remote, but candidates must reside in AZ, FL, GA, ID, IA, KY, MI, MS, NE, NM, NY (outside Greater ... medical claim review including DRG Validation or Itemized Bill Review, including 2 years ...

Sygnetics, Inc

Remote Medical Coder II

Louisville, KY · Remote

$38.09/hr

Remote Medical Coder III US Citizenship required. We are currently assembling a team of skilled ... Collaborates with and supports medical coding auditors, trainers, and compliance specialists in ...

Humana, Inc.

Medical Coding Auditor

Complete appropriate system(s) entry regarding claim/encounter information * Support and ... Remote, work at home. While this is a remote position, occasional travel to Humana's offices for ...

Imagenet

Claims Quality Auditor - Remote

Tampa, FL · On-site +1

Experience with other claim adjudication platforms and provider systems. * Familiarity with DHCS ... Medical, Dental, Vision, Life, HSA, 401(k) * Paid Time Off (PTO) * 7 paid holidays * A supportive ...

Imagenet

Claims Quality Auditor - Remote

Tampa, FL · Remote

Experience with other claim adjudication platforms and provider systems. * Familiarity with DHCS ... Medical, Dental, Vision, Life, HSA, 401(k) * Paid Time Off (PTO) * 7 paid holidays * A supportive ...

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Remote Medical Claim Auditor information

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How much do remote medical claim auditor jobs pay per hour?

As of Jun 15, 2026, the average hourly pay for remote medical claim 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 are the key skills and qualifications needed to thrive as a Remote Medical Claim Auditor, and why are they important?

To thrive as a Remote Medical Claim Auditor, you need a solid understanding of medical billing and coding, healthcare regulations, and insurance claims processes, often supported by a degree in health information management or a related field. Familiarity with auditing software, electronic health records (EHR) systems, and certifications such as CPC (Certified Professional Coder) or CPMA (Certified Professional Medical Auditor) are typically required. Strong attention to detail, analytical thinking, and effective communication skills help auditors identify discrepancies and collaborate with healthcare providers. These skills and qualifications are vital for ensuring accuracy, compliance, and cost savings in healthcare reimbursement.

How do Remote Medical Claim Auditors typically collaborate with healthcare providers and insurance teams while working off-site?

Remote Medical Claim Auditors routinely engage with healthcare providers and insurance teams through secure digital platforms, email, and virtual meetings. They review claims data, clarify documentation, and resolve discrepancies by communicating directly with billing departments and insurance representatives. Effective collaboration relies on clear, timely communication and a strong understanding of compliance regulations. While working independently, auditors are still part of a broader team, often participating in regular check-ins and process improvement discussions.

What does a Remote Medical Claim Auditor do?

A Remote Medical Claim Auditor reviews and evaluates healthcare claims to ensure accuracy, compliance with regulations, and proper documentation. They work from a remote location, analyzing medical records and billing information to identify errors, fraud, or overpayments. Their goal is to ensure that healthcare providers and insurance companies process claims correctly and adhere to industry standards. This role often involves communicating findings, recommending corrective actions, and sometimes working with multiple software systems. Attention to detail and knowledge of medical coding and billing practices are essential for success in this position.

What is the difference between Remote Medical Claim Auditor vs Remote Medical Billing Specialist?

AspectRemote Medical Claim AuditorRemote Medical Billing Specialist
CredentialsCertifications like CPC, CPC-H, or equivalentCertifications like CPC, CPC-H, or equivalent
Work EnvironmentHealthcare insurance companies, third-party administrators, or healthcare providersMedical offices, billing companies, or healthcare providers
Job FocusReviewing and auditing insurance claims for accuracy and compliancePreparing and submitting insurance claims, following up on payments

Both roles require similar certifications and often operate within healthcare or insurance environments. The key difference is that Remote Medical Claim Auditors focus on reviewing claims for accuracy and compliance, while Remote Medical Billing Specialists handle the submission and management of claims. Understanding these distinctions helps job seekers identify the right role based on their skills and career goals.

More about Remote Medical Claim Auditor jobs
What cities are hiring for Remote Medical Claim Auditor jobs? Cities with the most Remote Medical Claim Auditor job openings:
What are the most commonly searched types of Medical Claim Auditor jobs? The most popular types of Medical Claim Auditor jobs are:
What states have the most Remote Medical Claim Auditor jobs? States with the most job openings for Remote Medical Claim Auditor jobs include:
What job categories do people searching Remote Medical Claim Auditor jobs look for? The top searched job categories for Remote Medical Claim Auditor jobs are:
Remote Medical Claim Auditor jobs near you
Infographic showing various Remote Medical Claim Auditor job openings in the United States as of June 2026, with employment types broken down into 100% Full Time. Highlights an 95% Physical, 1% Hybrid, and 4% Remote job distribution, with an average salary of $53,259 per year, or $25.6 per hour.

Senior Stoploss Claim Auditor

Ourhrconnect

San Francisco, CA • Remote

$77K - $101K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 6 days ago

Job description


Summary
Description
 

Position Purpose:

Audit and authorize reimbursement of specific and/or aggregate medical stop loss claims. Effectively mitigate client medical stop loss claims and provide excellent customer service.

Logistics: iiSi | Writing Medical Stop Loss Across the Nation - one of BlueCross BlueShield's South Carolina subsidiary companies.

Location: This position is full-time (40 hours/week) Monday-Friday from 8:00am-5:00pm EST and will be fully remote.

What You'll Do:

  • Analyze and adjudicate stop loss claims and request appropriate reimbursement from carrier. Recognize cost mitigation opportunities. Authorize and release stop loss claims reimbursement checks at or below pre-set authority limits.

  • Initiate claims investigations and vendor referrals. Interpret plan language, and identify experimental services and subrogation opportunities. Identify need for follow-up on pended claims and resolution.

  • Communicate effectively with carriers, vendors, and management. Provide full claims service to both phone and written inquiries.

  • Generate and maintain claims system reports to adjust reserves, identify pending and backlog claims, and provide renewal and enrollment/premium history.

  • Develop new and review old stop loss claim forms. Assist with internal auditing of claims auditors, and training of claims auditors.

To Qualify for This Position, You'll Need the Following:

  • Required Education: Associate's

  • Required Work Experience: 6 years of managed care or reinsurance claims experience.

We Prefer That You Have the Following:

  • Preferred Skills and Abilities:

  • Analyzes laws, regulations and contract language.

  • Evaluates issues and develops recommendations.

  • Handles confidential and sensitive information.

  • Investigates assigned claims.

  • Proposes claims adjustments and refunds.

  • Works claims caseloads.

  • Aggregate claims experience.

Our Comprehensive Benefits Package Includes the Following:

We offer our employees great benefits and rewards. You will be eligible to participate in the benefits for the first of the month following 28 days of employment.

  • Subsidized health plans, dental and vision coverage

  • 401k retirement savings plan with company match

  • Life Insurance

  • Paid Time Off (PTO)

  • On-site cafeterias and fitness centers in major locations

  • Education Assistance

  • Service Recognition

  • National discounts to movies, theaters, zoos, theme parks and more

What We Can Do for You:

We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.

What To Expect Next:

After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements.

Pay Range Information:

Range Minimum

$53,320.00

Range Midpoint

$77,519.00

Range Maximum

$101,718.00

Pay Transparency Statement:

Please note that this range represents the pay range for this and other positions that fall into this pay grade. Compensation decisions within the range will be dependent upon a variety of factors, including experience, geographic location, and internal equity.

Equal Employment Opportunity Statement

BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilitiesand protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations.

We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company.

If you need special assistance or an accommodation while seeking employment, please email mycareer.help@bcbssc.comor call 800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.

We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here's moreinformation.

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