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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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 ...
Medical Coding Auditor
Ithaca, NY · Remote
$67K - $76K/yr
Understanding of billing platforms and claim workflows--how coding feeds into reimbursement ... Remote
Medical Coding Auditor
Ithaca, NY · Remote
$67K - $76K/yr
Understanding of billing platforms and claim workflows--how coding feeds into reimbursement ... Remote
Medical Coding Auditor
Ithaca, NY · Remote
$67K - $76K/yr
Understanding of billing platforms and claim workflows--how coding feeds into reimbursement ... Remote
Medical Coding Auditor
Ithaca, NY · Remote
$67K - $76K/yr
Understanding of billing platforms and claim workflows--how coding feeds into reimbursement ... Remote
Clinical Consultant - Remote
Chicago, IL · Remote
$72K - $130K/yr
Co-manage complex medical cases with Transplant/Dialysis coordinator * Provide clinical claim file review for claims auditor as needed. (5%) * Perform appropriate research for each clinical claim ...
Clinical Consultant - Remote
Chicago, IL · Remote
$72K - $130K/yr
Co-manage complex medical cases with Transplant/Dialysis coordinator * Provide clinical claim file review for claims auditor as needed. (5%) * Perform appropriate research for each clinical claim ...
Auditor, Sr Stoploss Claim
Kansas, OK · On-site +1
$74K - $97K/yr
Effectively mitigate client medical stop loss claims and provide excellent customer service ... remote or hybrid if based near our Dallas office. What You'll Do: * Analyze and adjudicate stop ...
Auditor, Sr Stoploss Claim
Kansas, OK · On-site +1
$74K - $97K/yr
Effectively mitigate client medical stop loss claims and provide excellent customer service ... remote or hybrid if based near our Dallas office. What You'll Do: * Analyze and adjudicate stop ...
Auditor, Sr Stoploss Claim
Alexandria, VA · On-site +1
$74K - $97K/yr
Effectively mitigate client medical stop loss claims and provide excellent customer service ... remote or hybrid if based near our Dallas office. What You'll Do: * Analyze and adjudicate stop ...
Auditor, Sr Stoploss Claim
Alexandria, VA · On-site +1
$74K - $97K/yr
Effectively mitigate client medical stop loss claims and provide excellent customer service ... remote or hybrid if based near our Dallas office. What You'll Do: * Analyze and adjudicate stop ...
Auditor, Sr Stoploss Claim
Pace, FL · On-site +1
$74K - $97K/yr
Effectively mitigate client medical stop loss claims and provide excellent customer service ... remote or hybrid if based near our Dallas office. What You'll Do: * Analyze and adjudicate stop ...
Auditor, Sr Stoploss Claim
Pace, FL · On-site +1
$74K - $97K/yr
Effectively mitigate client medical stop loss claims and provide excellent customer service ... remote or hybrid if based near our Dallas office. What You'll Do: * Analyze and adjudicate stop ...
$74K - $97K/yr
Effectively mitigate client medical stop loss claims and provide excellent customer service ... remote or hybrid if based near our Dallas office. What You'll Do: * Analyze and adjudicate stop ...
$74K - $97K/yr
Effectively mitigate client medical stop loss claims and provide excellent customer service ... remote or hybrid if based near our Dallas office. What You'll Do: * Analyze and adjudicate stop ...
$74K - $97K/yr
Effectively mitigate client medical stop loss claims and provide excellent customer service ... remote or hybrid if based near our Dallas office. What You'll Do: * Analyze and adjudicate stop ...
$74K - $97K/yr
Effectively mitigate client medical stop loss claims and provide excellent customer service ... remote or hybrid if based near our Dallas office. What You'll Do: * Analyze and adjudicate stop ...
Medical Program Integrity Auditor
Westborough, MA · On-site +1
$80K - $95K/yr
Onsite requirement 1-2 times per month, all other aspects of the job are remote. Responsibilities ... care claim audits, administrative medical record reviews or other claims analysis related ...
Medical Program Integrity Auditor
Westborough, MA · On-site +1
$80K - $95K/yr
Onsite requirement 1-2 times per month, all other aspects of the job are remote. Responsibilities ... care claim audits, administrative medical record reviews or other claims analysis related ...
$74K - $97K/yr
Effectively mitigate client medical stop loss claims and provide excellent customer service ... remote or hybrid if based near our Dallas office. What You'll Do: * Analyze and adjudicate stop ...
$74K - $97K/yr
Effectively mitigate client medical stop loss claims and provide excellent customer service ... remote or hybrid if based near our Dallas office. What You'll Do: * Analyze and adjudicate stop ...
$74K - $97K/yr
Effectively mitigate client medical stop loss claims and provide excellent customer service ... remote or hybrid if based near our Dallas office. What You'll Do: * Analyze and adjudicate stop ...
$74K - $97K/yr
Effectively mitigate client medical stop loss claims and provide excellent customer service ... remote or hybrid if based near our Dallas office. What You'll Do: * Analyze and adjudicate stop ...
$74K - $97K/yr
Effectively mitigate client medical stop loss claims and provide excellent customer service ... remote or hybrid if based near our Dallas office. What You'll Do: * Analyze and adjudicate stop ...
$74K - $97K/yr
Effectively mitigate client medical stop loss claims and provide excellent customer service ... remote or hybrid if based near our Dallas office. What You'll Do: * Analyze and adjudicate stop ...
$74K - $97K/yr
Effectively mitigate client medical stop loss claims and provide excellent customer service ... remote or hybrid if based near our Dallas office. What You'll Do: * Analyze and adjudicate stop ...
$74K - $97K/yr
Effectively mitigate client medical stop loss claims and provide excellent customer service ... remote or hybrid if based near our Dallas office. What You'll Do: * Analyze and adjudicate stop ...
Auditor, Sr Stoploss Claim
Iowa, LA · On-site +1
$74K - $97K/yr
Effectively mitigate client medical stop loss claims and provide excellent customer service ... remote or hybrid if based near our Dallas office. What You'll Do: * Analyze and adjudicate stop ...
Auditor, Sr Stoploss Claim
Iowa, LA · On-site +1
$74K - $97K/yr
Effectively mitigate client medical stop loss claims and provide excellent customer service ... remote or hybrid if based near our Dallas office. What You'll Do: * Analyze and adjudicate stop ...
Auditor, Sr Stoploss Claim
California, MD · On-site +1
$74K - $97K/yr
Effectively mitigate client medical stop loss claims and provide excellent customer service ... remote or hybrid if based near our Dallas office. What You'll Do: * Analyze and adjudicate stop ...
Auditor, Sr Stoploss Claim
California, MD · On-site +1
$74K - $97K/yr
Effectively mitigate client medical stop loss claims and provide excellent customer service ... remote or hybrid if based near our Dallas office. What You'll Do: * Analyze and adjudicate stop ...
Auditor, Sr Stoploss Claim
Louisiana, MO · On-site +1
$74K - $97K/yr
Effectively mitigate client medical stop loss claims and provide excellent customer service ... remote or hybrid if based near our Dallas office. What You'll Do: * Analyze and adjudicate stop ...
Auditor, Sr Stoploss Claim
Louisiana, MO · On-site +1
$74K - $97K/yr
Effectively mitigate client medical stop loss claims and provide excellent customer service ... remote or hybrid if based near our Dallas office. What You'll Do: * Analyze and adjudicate stop ...
$74K - $97K/yr
Effectively mitigate client medical stop loss claims and provide excellent customer service ... remote or hybrid if based near our Dallas office. What You'll Do: * Analyze and adjudicate stop ...
$74K - $97K/yr
Effectively mitigate client medical stop loss claims and provide excellent customer service ... remote or hybrid if based near our Dallas office. What You'll Do: * Analyze and adjudicate stop ...
$74K - $97K/yr
Effectively mitigate client medical stop loss claims and provide excellent customer service ... remote or hybrid if based near our Dallas office. What You'll Do: * Analyze and adjudicate stop ...
$74K - $97K/yr
Effectively mitigate client medical stop loss claims and provide excellent customer service ... remote or hybrid if based near our Dallas office. What You'll Do: * Analyze and adjudicate stop ...
Auditor, Sr Stoploss Claim
Nevada, IA · On-site +1
$74K - $97K/yr
Effectively mitigate client medical stop loss claims and provide excellent customer service ... remote or hybrid if based near our Dallas office. What You'll Do: * Analyze and adjudicate stop ...
Auditor, Sr Stoploss Claim
Nevada, IA · On-site +1
$74K - $97K/yr
Effectively mitigate client medical stop loss claims and provide excellent customer service ... remote or hybrid if based near our Dallas office. What You'll Do: * Analyze and adjudicate stop ...
Remote Medical Claim Auditor information
See salary details
$14.66 - $17.88
24% of jobs
$17.98 is the 25th percentile. Wages below this are outliers.
$17.88 - $21.09
40% of jobs
$21.09 - $24.30
10% of jobs
$24.60 is the 75th percentile. Wages above this are outliers.
$24.30 - $27.51
8% of jobs
$27.51 - $30.73
0% of jobs
$30.73 - $33.94
0% of jobs
$33.94 - $37.15
0% of jobs
$37.15 - $40.36
0% of jobs
$40.36 - $43.58
0% of jobs
$43.58 - $46.79
10% of jobs
$46.79 - $50
7% of jobs
$14
$25
$50
How much do remote medical claim auditor jobs pay per hour?
As of Jun 16, 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?
| Aspect | Remote Medical Claim Auditor | Remote Medical Billing Specialist |
|---|---|---|
| Credentials | Certifications like CPC, CPC-H, or equivalent | Certifications like CPC, CPC-H, or equivalent |
| Work Environment | Healthcare insurance companies, third-party administrators, or healthcare providers | Medical offices, billing companies, or healthcare providers |
| Job Focus | Reviewing and auditing insurance claims for accuracy and compliance | Preparing 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:
- Overnight Remote Medical Billing & Coding
- Remote Pediatric Medical Coder
- Remote Medical Monitoring
- Overnight Remote Medical Records
- Remote Aetna Medical Coding
- Freelance Pay Per Chart Medical Coder
- From Home Aetna Medical Coding
- Remote Cvs Medical Billing
- Remote R1 Rcm Medical Coding
- Vice President Remote Medical Billing & Coding
Other
Medical, Dental, Vision, Life, Retirement, PTO
Posted 14 days ago
Job description
Salary:
Claims Quality Auditor| Remote
Job Type: Full time
Work Setup: Remote
Reports to: Claims Supervisor
Position Summary:
TheClaims Quality Auditor plays a key role in ensuring the accuracy, compliance, and effectiveness of claims processing and provider dispute resolution. The ideal candidatehas hands on experience withEZCap,auditing claims, analyzing dispute claims and evaluating internal policies and regulatory requirements, with a particular focus on Medi-Cal and commercial health plans.This role is responsible to partners closely with cross-functional teams to drive continuous improvement and operational excellence.
Key Duties:
- Perform detailed audits of denied, underpaid, and processed claims using EZCap to assess accuracy and compliance with provider contracts and regulatory guidelines.
- Analyze provider disputes for patterns or recurring issues.
- Identify root causes and work with relevant teams to implement corrective actions and process improvements.
- Develop and track performance related to claims accuracy, turnaround time, and dispute resolution efficiency.
- Conduct thorough root cause analyses on high-impact errors or escalations.
- Support training initiatives by identifying knowledge gaps and assisting in the development of updated procedures and documentation based on audit results.
- Ensure all reviewed processes align with applicable regulatory requirements. Participate in internal and external audits as needed.
Qualifications:
- High school diploma or equivalent
- At least 3-5 years of Quality Analyst in healthcare,TPA, or health plan settings/ healthcare claims or in a claims processing/adjudication environment
- Hands-on experience with EZCap (strongly preferred)
- Familiarity with Medi-Cal and Commercial insurance claim
- Strong analytical and problem-solving skills
- Excellent verbal and written communication
- Attention to detail in documentation and compliance
- Ability to manage multiple tasks and meet deadlines
- Experience with other claim adjudication platforms and provider systems.
- Familiarity with DHCS, DMHC, CMS dispute handling regulations.
What We Offer
- Remote work offered
- Equipment provided
- Paid training to set you up for success
- Comprehensive benefits: Medical, Dental, Vision, Life, HSA, 401(k)
- Paid Time Off (PTO)
- 7 paid holidays
- A supportive team and a company that values internal growth
COMPANY OVERVIEW:
Imagenet is a leading provider of back-office support technology and tech-enabled outsourced services to healthcare plans nationwide. Imagenet provides claims processing services, including digital transformation, claims adjudication and member and provider engagement services, acting as a mission-critical partner to these plans in enhancing engagement and satisfaction with plans members and providers.
The company currently serves over 70 health plans, acting as a mission-critical partner to these plans in enhancing overall care, engagement and satisfaction with plans members and providers. The company processes millions of claims and multiples of related structured and unstructured data elements within these claims annually. The company has also developed an innovative workflow technology platform, JetStreamTM, to help with traceability, governance and automation of claims operations for its clients.
Imagenet is headquartered in Tampa, operates 10 regional offices throughout the U.S. and has a wholly owned global delivery center in the Philippines.