Claims Auditor (Healthcare Claims)

Location: Remote-FL; must be authorized to work in the United States

Salary: $19.43–$32.98 per hour

Company

hirify.global provides healthcare services and supports access to care for individuals, families, and communities.

What you will do

• Perform routine and moderately complex audits of claims adjudication processes.
• Identify and report quality issues, exceptions, patterns, and trends affecting business units, clients, and customers.
• Review contested claims and research the origins of claim-processing problems and errors.
• Enter audit data into databases and develop reports based on findings.
• Provide coaching and feedback to examiners, trainers, and management.
• Recommend workflow, policy, procedure, and training improvements to prevent recurring errors.

Requirements

• High school diploma required.
• At least one year of relevant experience.
• In-depth experience with healthcare claims, contracts, benefit application, and coordination of benefits.
• Knowledge of policies, procedures, compliance regulations, schedules of benefits, and turnaround times across product lines.
• U.S. work authorization is required; employment-based visa sponsorship is not available now or in the future.

Culture & Benefits

• Health insurance, 401(k), stock purchase plans, tuition reimbursement, paid time off, and holidays.
• Flexible work approaches including remote, hybrid, field, and office schedules.
• Work focused on improving healthcare access and outcomes.
• Equal opportunity workplace committed to diversity and inclusion.