Dedicated Claims Auditor

Healthcare shouldn’t be something you worry about when taking care of your family. That’s why when you join Redirect Health, your healthcare costs nothing out of your paycheck—and the same is true for your spouse and children. No monthly premiums No deductibles No surprise medical bills Most team members avoid tens of thousands of dollars in healthcare costs compared to traditional health plans. This isn’t a perk. It’s part of our mission. Who We Are Redirect Health exists to make healthcare affordable for small businesses and people who can’t afford traditional employer insurance. We help real people navigate a system that is often confusing, expensive, and frustrating—and we do it with empathy, accountability, and simplicity. If you want your work to matter to families every single day, you’ll find purpose here. How We Work (Our Core Values in Action) At Redirect Health, our values guide how we show up for each other, our clients, and our members. We do our best work when we: Obsess Over People – We are always helpful, friendly, and human Own It to Completion – If we take something on, we see it through Always Improve & Adapt – We learn quickly and adjust without ego Start with “Yes, We Can Help You” – We lead with solutions Succeed as a Team – We win through trust and collaboration Detest Waste & Unnecessary Complexity – We simplify to focus on what matters About This Role At Redirect Health, we’re on a mission to make healthcare accessible and affordable for everyone. We are currently accepting applications for a Dedicated Claims Auditor. Are you a healthcare professional who thrives in a fast-paced, adaptable environment and is passionate about delivering exceptional service? We’re looking for a Dedicated Claims Auditor to oversee and ensure comprehensive medical and pharmacy claims auditing practices for our members. This is an opportunity to make a direct impact, examine and improve workflows, and support the Claims Management team in sustaining our vision of 0% Error Rates —all while helping people access the care they need. What You’ll Do In this role, you will: Claims Audit, Review, & Quality Assurance o Perform detailed audits of medical and pharmacy claims to verify payment accuracy, coding appropriateness, and adherence to plan provisions. o Validate claims against internal reimbursement methodologies, contracts, fee schedules, and plan documents. o Review high-dollar, complex, and outlier claims for billing accuracy and reimbursement integrity. Payment Integrity and Cost Containment o Identify claim overpayments, underpayments, and recovery opportunities. o Analyze reimbursement trends and claim payment anomalies. o Support recovery efforts through reprocessing recommendations and financial impact analyses. o Recommend process improvements to reduce claim leakage and optimize plan spend. What We’re Looking For We’re looking for someone who: Experience: 2+ years in a dedicated claims and/or auditing role, preferably in healthcare or customer service Skills: Strong system and rules analysis, problem-solving, and decision-making abilities. Excellent communication and interpersonal skills. Why Join Redirect Health What “Free Healthcare” Actually Means When we say free, we mean no money out of your paycheck and no cost when you need care: No monthly premiums No cost to add your spouse or children No deductibles (we reimburse them) No out-of-pocket maximums This benefit alone can save families tens of thousands of dollars. What You’ll Earn Salary range: $50,000 - $55,000 per year FREE healthcare for you and your entire family Dental & Vision insurance Paid time off & sick time 401(k) access A mission-driven team that believes in doing the right thing Legal Stuff Redirect Health is an Equal Opportunity Employer (EOE). Employment with Redirect Health is at-will. Nothing in this job posting or the application process creates a contract or guarantee of employment. Please note this job description is not designed to contain a comprehensive listing of activities, duties, or responsibilities required for this role. Duties, responsibilities, and activities may change at any time with or without notice. Redirect Health does not provide employment-based visa sponsorship now or in the future for this position. Applicants must be currently authorized to work in the United States without sponsorship. The pay range for this role is: 50,000 - 55,000 USD per year (Phoenix) #J-18808-Ljbffr redirect-health-careers