Claims Auditor: Medical Plan Audits & Coaching
Highmark Health
Highmark Health in the United States (KY region) seeks a Claims Audit Specialist with 5 years of medical claims processing experience in dental, vision, FSA and HRA. You will ensure claims follow procedures, monitor audits, record results, and coach staff to maintain accuracy and efficiency. You will support supervision, recommend dollar authorizations based on audit stats, conduct specialized audits, and test system upgrades. #J-18808-Ljbffr Highmark Health
$23.73 - $35.6 per hour
...application process. Claims Auditor I Doral, FL, US 3 days... ...pre- and post-payment audits of claims processed by... ...a managed care health plan environment. The auditor... ...requirements Medical necessity in accordance... ...structured feedback and coaching insights to claim examiners...MedicalClaimsHourly pay- ...team: The Chubb Internal Audit (IA) department has... ...the role: This Senior Auditor position offers an opportunity... ...for underwriting, claims, and other critical operational... ...process, such as audit planning (lead walkthroughs,... ...physical disability, medical condition, genetic...MedicalClaimsLocal area
$46.99k - $122.4k
...The Program Integrity Auditor is responsible for the review of records for medical, behavioral, transportation... ...include reviews/audits of provider records to... ...funds or rebilling of claims, and referral to state... ...team member for a health plan(s) which currently administers...MedicalClaimsHourly payFull timeTemporary workLocal areaMonday to FridayFlexible hours$59.3k - $80.9k
...a part of our caring community The Medical Coding Auditor reviews medical claims submitted against medical records provided... ...experience Outpatient facility auditing experience Experience with coding/... ...is eligible for a bonus incentive plan. This incentive opportunity is...MedicalClaimsBi-weekly payContract workTemporary workApprenticeshipWork at officeRemote workWork from homeHome officeMonday to Friday- ...!**Job Title: Compliance Auditor****Department:** Compliance... ...conducting compliance auditing, monitoring, and risk assessment... ...clinical documentation, medical records, billing, coding, claims submission, service... ...medical necessity, treatment planning, service delivery,...MedicalClaimsTemporary workWork at office
- ...operational and assurance audit projects: Leads... ...partners to develop action plans to address identified issues... ...to the project, and coaches them toward their... ...as reviewing a specific claim, policy transaction or... ...or mental disability, medical condition, veteran status...MedicalClaimsInternshipLocal areaWork from home
$68k - $90k
...Maimonides Medical Center Billing And Coding Supervisor... ...routine and scheduled audits of data reported by all... ...the Medical Center has claimed and ensures those encounters... ..., creates an audit plan to review issues... ...accuracy of data entry Coaches coding and billing specialists...MedicalClaims$21.96 per hour
...position. E1. Ensure all claims are handled according... ...procedures along with reviewing plan wording for each... ...2. Monitor workflow of audits to ensure timely... ...E5. Conduct one on one coaching with the claims team especially... ...: 5 years prior medical dental, vision, FSA and...MedicalClaimsFor contractorsTraineeshipLocal area- ...of America) Standard Weekly Hours: 40 Summary The Claim Auditor I is responsible for auditing behavioral and medical claims and ensuring quality metrics are met by... ...federal programs (Medicaid, CHIP) or in a health plan/payor environment preferred. 7-10 years of medical...MedicalClaimsWork at officeShift workDay shift
$34.29 per hour
...OVERVIEW: Senior most coding auditor who evaluates medical records to determine the... ...to DRG, OPPS and outpatient claims. Reports findings both verbally... ...to external coding audits conducted by the Medicare Administrative... ...and/or teaching plans in accordance with federal...MedicalClaimsFor contractorsLocal area$175 per hour
...team, the Contract Clinical Auditor will perform independent... ...clinical reviews of disability claims. The Auditor will evaluate medical records, determine... ...timely, objective clinical audits of disability claim files... ...policy language, benefit plan terms, and regulatory frameworks...MedicalClaimsHourly payContract workTemporary workWork at officeRemote workFlexible hours$75k - $85k
...Purpose: The Staff Auditor II’s primary focus is... ...to perform internal audit activities with growing... ...assignments from planning through reporting and may coach Staff Auditors on assigned... ...Comprehensive medical, dental, and vision... ...risk engineering and claims management services...ClaimsTemporary workWork experience placementWork at officeLocal areaRemote workFlexible hours- ...management to payment integrity, plan performance and provider... ...Review Analyst, you’ll review claims upfront and take a deeper dive... ...Things You’ll Do Here: Review medical bills to identify appropriate... ...Bring to the Team: 3+ years of auditing, claims, review and/or billing...MedicalClaimsImmediate startRemote workFlexible hours
$61.5k - $98.3k
...technology and exceptional service. Audit Services offers financial... ...onboarding, training, and coaching, you will build your expertise... ...of audit engagements from planning through reporting Analyze processes... ...health and welfare benefits (medical, dental, vision, spending...MedicalH1bWork at officeWork from homeWorldwideFlexible hours- ...compliance, and operational audits, business advisory and consultation... ...management. Assists other auditors in completing their... ...Following Subsidized health plans dental and vision coverage 40... ...largest providers of high-volume medical claims and transaction processing. We...MedicalClaimsFull timeFor contractorsWork experience placementSecond jobWork at officeLocal areaRemote workMonday to Friday
- ...meet company standards Report damages and claims to inventory control Arrange stock parts in... ...safe, stable, reliable work environments, medical, dental, and basic life and disability insurance benefits, 401k retirement plan, paid time off, annual bonus eligibility, and...MedicalClaimsWork at officeLocal areaWorldwideFlexible hours
- ...RESPONSIBILITIES The Senior Internal Auditor supports the company’s... ...The incumbent reports audit findings to leadership... ...and track remediation plans through resolution.... ...compensation packages Medical, Dental and Vision 401k... ...will preclude any claim that the employer failed...MedicalClaimsH1bRelocationRelocation package
- ...IQVIA LLC in Houston is seeking a Billing Coordinator to ensure timely and accurate submission of medical claims. The role supports value-based care billing and requires strong attention to detail and compliance with HIPAA. The position demands 5+ years in medical billing...MedicalClaimsWork at officeRemote work
$92.82k - $109.2k
## Senior Auditor - Payment ServicesApplylocations: Minneapolis... ...**The Corporate Audit Services Senior Auditor... ...team management in planning audit engagements. Includes... ...from and applying coaching received.* Performing other... ...:* Healthcare (medical, dental, vision)* Basic...MedicalTemporary workWork experience placementWork at officeLocal area3 days per week- ...Payment Accuracy and Concept Lead to identify medical billing errors and fraudulent patterns... ...You will lead concept development across audit verticals, collaborating with Medical... ...coding guidelines, DRG methodologies, and claims adjudication processes. #J-18808-Ljbffr...MedicalClaims
- ...receive an alert: Internal Auditor Date: Aug 19, 2026... ...report to the Internal Audit Manager and support the... ...will assist with audit planning, walkthroughs, testing,... ...and responsiveness to coaching. Ability to work effectively... ...childbirth or related medical condition, including...MedicalWork at office
$83k - $99.45k
...it. The Senior Internal Auditor plays a key role in... ...lead and execute complex audit and advisory engagements... ...of team members through coaching and knowledge sharing.... ...In this role, you will plan and execute risk-based... ...childbirth, or related medical condition, military or...MedicalFor contractorsWork at officeWorldwide- Vālenz Health seeks a Clinical Bill Review Analyst to audit and review medical bills, identify coding errors, and uncover savings opportunities. You will analyze complex claims, collaborate with negotiation teams, and report findings to clients while ensuring HIPAA compliance...MedicalClaimsRemote job
- ## Medical Coding AuditorApplyremote type: Remote USlocations: Remote... ...a driven **Medical Coding Auditor** to join our positive, passionate... ...standards and supporting audit and denial management processes... ...provides needed corrections of these claims when applicable, and performs...MedicalClaimsWork at officeLocal areaRemote workFlexible hours
- UnitedHealth Group is seeking a Medical Coding Auditor to determine the accuracy of claims by comparing to medical records and to identify waste and errors in a telecommuting role across the U.S. The position requires AHIMA or AAPC certification and 2+ years in coding...MedicalClaimsRemote job
- UnitedHealth Group is seeking a Medical Coding Auditor to verify claims accuracy by comparing to medical records, performing code reviews, and ensuring compliance across state and federal guidelines. You’ll telecommute from anywhere in the U.S. and join a team focused on...MedicalClaimsRemote job
- Humana Inc. is seeking a Medical Coding Auditor for its Outpatient Facility/APC Coding Team. This remote role reviews claims, ensures CPT/HCPCS compliance, and interprets medical records to support accurate payments. Occasional travel to Humana offices may be required for...MedicalClaimsRemote job
- ...in Conshohocken, PA, seeks a Contract Clinical Auditor to perform independent reviews of disability claims within our Absence, Disability, and Life team. Remote... ...work options supported; daily duties include auditing medical records, evaluating functional capacity, and...MedicalClaimsRemote jobContract work
- Allegheny Health Network is seeking a Senior Coding Auditor to evaluate medical records for DRG, OPPS and outpatient claim accuracy. You will report findings verbally and in writing, and guide education, process changes and risk reduction across the system. The role involves...MedicalClaims
- UnitedHealth Group is seeking a Medical Coder to apply diagnostic and procedural codes to patient records, ensuring accuracy for data retrieval and claims processing. The role supports nephrology services across the outpatient hospital setting, coding per official guidelines...MedicalClaimsRemote jobFull time
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Claims Auditor: Medical Plan Audits & Coaching. Be the first to apply!
- information system auditor Brooklyn, NY
- staff auditor Brooklyn, NY
- coding auditor Brooklyn, NY
- security auditor Brooklyn, NY
- energy auditor Brooklyn, NY
- medical records auditor Brooklyn, NY
- premium auditor Brooklyn, NY
- inventory auditor Brooklyn, NY
- entry level auditor Brooklyn, NY
- remote auditor Brooklyn, NY

