Medical Auditor II

Medical Auditor Position

When you hear the term auditor, do you think of mountains of paperwork and digging through files with a fine-tooth comb? As a medical auditor for SAIF, you'll work in a computerized, fast-paced production environment to ensure payments to medical providers are accurate and timely. No reams of paper for this job. A medical auditor does more than review medical bills and ensure correct payment amounts. You'll serve as the primary point of contact for medical providers, claims adjusters, and other parties involved in medical bill payment. You will also be explaining payment amounts, answering their questions and explaining workers compensation rules. If you like working on a team in a fast-paced environment, and you know your way around medical bills, chart notes, and coding, we invite you to apply. Please note: Flexible workers may be required to travel to SAIF's offices in Salem, Oregon.

Responsibilities:

• Review automated audit results and documentation and make adjustments to audit results when necessary to reflect correct payment amounts in accordance with accepted condition, policies, guidelines, coding standards and regulations. Forward audit recommendation to claims adjuster for final review and payment determination or approve bills for payment based on claims adjuster direction, or guidelines.
• Research medical audit and system issues and communicate this information with recommended actions to internal and external customers, including claims adjusters, medical providers, and MCOs. Explain pertinent laws, rules, and policies, to internal and external customers, including claims adjusters, medical providers, and MCOs and how the policies impact audit recommendations.
• Recognize services requiring complex review and forward to the designated resource for resolution.
• Report unusual billing patterns to supervisor for assessment, follow up and referral to the Investigations unit when applicable.
• Requests refunds from providers when overpayments occur.
• Process prescription drug authorizations and billings through pharmacy benefit on-line system, using knowledge of standard pharmacy codes and SAIF's policies. Communicate with claims adjusters and pharmacies regarding issues related to processing drug prescriptions.
• Explore diverse perspectives and consistently behave sensitively toward differences in cultural norms, expectations, and ways of communicating. Work effectively with others who have different perspectives, backgrounds, and/or work styles.
• Continually sustain the Inclusive Leadership Competencies (ILC) through the Explorer level on an annual basis.

Recommended qualifications:

• Three or more years of experience processing medical insurance billings and using medical terminology, ICD-10 and CPT codes.
• High school graduation or equivalent education and completion of medical terminology and ICD-10/CPT code courses.
• Other combinations of skills and experience may be considered.

Next step

To receive consideration, please submit your resume with a cover letter by the close of this recruitment. We want your submission to count, so be sure it's complete.

This recruitment will close on Thursday, June 4, 2026.

If a sufficient number of qualified applications are received this recruitment may close early.

Compensation & Benefits

Typical hiring range: $63,835 - $75,100. The pay range for this position is annually based on a full-time schedule. Actual compensation will be determined using factors such as experience, skills, training, certifications & education.

SAIF provides a wide range of benefits to employees who work at least 20 hours per week, including health care, retirement savings plans, paid time off, and more. For additional information about SAIF's total rewards, visit our website at: Total rewards (saif.com)

*Note that eligibility and cost of benefits can vary depending on the number of regularly scheduled hours, and job status such as regular full-time, regular part-time, seasonal, or temporary employment.

Full salary range: $56,325 - $93,875

Veterans

We provide preference to qualifying and disabled veterans. For more information please visit saif.com/veterans.

About us

Since 1914, SAIF has been taking care of injured workers, helping people get back to work, and keeping rates low by focusing on workplace safety. Together with our partners, we strive to make Oregon the safest and healthiest place to work.

For questions related to this job, please reach out to us at View email address on click.appcast.io.

SAIF is an Equal Opportunity Employer that values diversity in its workplace.