Skip to main content
Upload your CV and find your next job on Indeed!

Medical Auditor jobs

Sort by: -
    • Quality assurance, medical coding, or compliance certifications.
    • The ideal candidate will be responsible for auditing processed claims to ensure accuracy,…
    • View all vEnsure Healthtech Pvt. Ltd. jobs - Remote jobs - Quality Auditor jobs in Remote
    • Salary Search: Claims Quality Auditor salaries in Remote
    • The QA Auditor supports the functional head of QA in the provision of quality assurance activities within Novotech, primarily in audit activities.
  • View similar jobs with this employer
    • BA/BE Process clinical domain knowledge required.
    • Computer skills (MS-Word & Excel).
    • Good analytical skills and proactive thinking.
    • IMDR 2017, EU MDR 2017/745, EU IVDR 2017/746.
    • ISO 13485 Lead Auditor, ISO 14971 - Risk Management, Post-Market Surveillance (PMS) & Vigilance.
    • Manage and supervise the operations of an assigned cluster of dialysis centres.
    • Ensure uninterrupted delivery of dialysis services in accordance with…
    • Bachelor degree or above with medical device industry related major or main professional qualification in a relevant subject and have a comprehensive knowledge…
    • Proficiency in data collection, analysis, and deriving actionable insights from CMS medical policies, Medicaid Provider Manuals and other Medical publications.
    • Ability to mentor / train auditors and other personnel.
    • Support the training and mentoring of new / less experienced auditors by performing co-audits,…
    • Verify that all necessary clinical documentation is included to support claim submissions and medical necessity.
    • Adhere to project protocols and instructions.
    • Regeneron offers a competitive and comprehensive total rewards package which may include, depending on country and role: annual bonuses or other incentive plans…
    • Location: USA | Type: Full-time.
    • Reports to: Quality Lead / Program Lead.
    • Execute sampling plans (stratified by label type, difficulty, site/surgeon/device,…
    • Perform physical verification of medical equipment, fixed assets, and consumables.
    • Bachelor's degree in Commerce, Finance, Accounting, or Business…
    • Implement and maintain the pharmacovigilance system, quality process and metrics.
    • Conduct audits of projects, systems, processes, and vendors, as assigned.
    • 3–6 years in Internal Audit, Fraud Audit, Retail Audit, or Risk Management.
    • Experience in Optical Retail, Healthcare, Eye Care, or Multi-location Retail…
    • Qualified IMS & FSMS Auditors / Lead Auditors with 3-5 years experience in Third party auditing for Indian and International conformity assessment bodies.

People also searched:

internal auditor
medical assistant
medical officer
medical representative
medical representative fresher
medical scribe
medical store
auditor fresher
auditor office
bank audit

Job Post Details

Claims Quality Auditor - job post

vEnsure Healthtech Pvt. Ltd.
Remote
₹15,000 - ₹30,000 a month

Job details

Pay

  • ₹15,000 - ₹30,000 a month

Job type

  • Freelance
  • Full-time

Full job description

We are seeking a detail-oriented and analytical Claims Quality Auditor to join our Claims Operations team. The ideal candidate will be responsible for auditing processed claims to ensure accuracy, compliance, and adherence to company policies and regulatory requirements. This role plays a critical part in maintaining quality standards, identifying process improvement opportunities, and supporting operational excellence.

Key Responsibilities

  • Audit a sample or 100% of processed claims for data accuracy, pricing, coding, and adjudication correctness.
  • Verify that claim approvals and denials comply with company policies, client requirements, and regulatory standards.
  • Identify errors, omissions, inconsistencies, and potential fraud indicators within processed claims.
  • Provide constructive feedback and coaching to claims processors to improve quality and accuracy.
  • Support quality improvement initiatives and recommend process enhancements.
  • Ensure compliance with data privacy and confidentiality requirements, including HIPAA and other applicable regulations.
  • Prepare and present audit reports to management on a regular basis.

Required Qualifications

  • Prior experience in claims processing, claims adjudication, quality assurance, or auditing.
  • Strong understanding of claims processing workflows and adjudication rules.
  • Knowledge of coding structures such as ICD, CPT, HCPCS, or other industry-relevant coding systems.
  • Strong written and verbal communication skills.
  • Ability to identify trends, analyze data, and provide actionable recommendations.
  • Preferred Qualifications
  • Experience in healthcare, insurance, or managed care environments.
  • Quality assurance, medical coding, or compliance certifications.
  • Experience conducting audits and quality reviews in high-volume operational settings.
  • Knowledge of regulatory and compliance requirements related to claims processing.
  • Interested candidates are encouraged to apply and become part of a team committed to delivering accurate, compliant, and high-quality claims processing services.

Pay: ₹15,000.00 - ₹30,000.00 per month

Work Location: Remote

Let Employers Find YouUpload Your Resume