Mid Level Clinical Auditor Jobs
Mid level clinical auditor jobs go to professionals ready to own audit cycles end to end, synthesize findings independently, and guide less experienced team members without close supervision. Openings are spread across on-site, remote, and hybrid settings in Healthcare & Medical Services, Technology & Software, and Education, with employers like DaVita, Waystar, and Cotiviti hiring at this level now.
Find JobsOverview
Open roles7
Top statePennsylvania
Top employerDaVita
Top cityDuBois, PA
Work type75% Remote
Top industryHealthcare
Showing 5 of 7+ Mid Level Clinical Auditor jobs
DRG Validation Auditor (Clinical & Coding)
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Added 3w ago
Cotiviti
DRG Validation Auditor (Clinical & Coding)
Remote
Added 3w ago
Clinical Support Auditor
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Added 1mo ago
DaVita
Clinical Support Auditor
Denver, Colorado
Added 1mo ago
P
Clinical Charge Auditor Revenue Integrity DuBois CRC
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P
Added 2mo ago
Penn Highlands Mon Valley
Clinical Charge Auditor Revenue Integrity DuBois CRC
DuBois, Pennsylvania
Added 2mo ago
Contract Clinical Auditor
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Added 2mo ago
Marsh McLennan Agency
Contract Clinical Auditor
Conshohocken, Pennsylvania
Added 2mo ago
CDI Clinical Performance Auditor
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Added 3mo ago
Waystar
CDI Clinical Performance Auditor
Remote
Added 3mo ago
Added 3w ago
DRG Validation Auditor (Clinical & Coding)
Cotiviti·Remote
Job functions:
$45.67/hr
5+ yrs exp.
Associate of Science in Nursing
Full Time
5,001-10,000 employees
Job Description
Overview:
Start date is 8/31/2026 or 10/5/2026
Responsibilities:
Nonexempt employees are eligible to receive overtime pay for hours worked in excess of 40 hours in a given week, or as otherwise required by applicable state law.
Cotiviti offers team members a competitive benefits package to address a wide range of personal and family needs, including medical, dental, vision, disability, and life insurance coverage, 401(k) savings plans, paid family leave, 9 paid holidays per year, and 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti. For information about our benefits package, please refer to our Careers page.
Date of posting: 7/22/2026
#LI-Remote
This auditing role will focus on Coding & Clinical Chart Validation for our Inpatient audits (DRG Validation). The ideal candidate for this position needs to have both a clinical (nurse) and a coding / auditing background focused on the following disciplines from a coding and billing perspective: Inpatient DRG/APR-DRG. This position is responsible for auditing inpatient claims and documenting the results of those audits, with a focus on clinical review, coding accuracy, and the appropriateness of treatment setting and services delivered.
Start date is 8/31/2026 or 10/5/2026
- Analyzes and Audits Claims. Integrates medical chart coding principles, clinical guidelines and objectivity in performance of medical audit activities. Draws on advanced ICD-10 coding expertise, clinical guidelines, and industry knowledge to substantiate conclusions. Performs work independently.
- Effectively Utilizes Audit Tools. Utilizes Cotiviti proprietary auditing systems with a high level of proficiency to make audit determinations and generate audit letters.
- Meets or Exceeds Standards/Guidelines for Productivity. Maintains production goals set by the audit operations management team.
- Meets or Exceed Standards/Guidelines for Accuracy and Quality. Achieves the expected level of accuracy and quality set by the audit for the auditing concept, for valid claim, identification and documentation (letter writing).
- Identifies New Claim Types.
- Identifies potential claims outside of the concept where additional recoveries may be available.
- Suggests and develops high quality, high value concept and or process improvement, tools, etc.
- Complete all responsibilities as outlined on annual Performance Plan.
- Complete all special projects and other duties as assigned.
- Must be able to perform duties with or without reasonable accommodation.
- Complete all responsibilities as outlined on annual Performance Plan.
- Complete all special projects and other duties as assigned.
- Must be able to perform duties with or without reasonable accommodation.
This job description is intended to describe the general nature and level of work being performed and is not to be construed as an exhaustive list of responsibilities, duties, and skills required. This job description does not constitute an employment agreement and is subject to change as the needs of Cotiviti and the requirements of the job change.
Qualifications:
Education (at least one of the following are required):
- Associate or bachelor’s degree in nursing (active /unrestricted license).
- Associate or bachelor’s degree Health Information Management (RHIA or RHIT).
- High school diploma or GED plus equivalent experience of 5+ years’ experience in claims auditing, quality assurance, or recovery auditing...ideally in a DRG / Clinical Validation Audit setting or a hospital environment.
Coding/CDI Certification (at least one of the following are required and are to be maintained as a condition of employment):
- RHIA or RHIT.
- CPC.
- Inpatient Coding Credential – CCS, CIC, CDIP or CCDS.
Experience (required):
- 5 to 7+ years of working with ICD-9/10CM, MS-DRG, AP-DRG and APR-DRG with a broad knowledge of medical claims billing/payment systems provider billing guidelines, payer reimbursement policies, medical necessity criteria and coding terminology.
- Adherence to official coding guidelines, coding clinic determinations and CMS and other regulatory compliance guidelines and mandates. Requires expert coding knowledge - DRG, APRDRG, ICD-10, CPT, HCPCS codes.
- Requires working knowledge of and applicable industry-based standards.
- Proficiency in Word, Access, Excel, TEAMS, and other applications.
- Excellent written and verbal communication skills.
Mental Requirements:
- Communicating with others to exchange information.
- Assessing the accuracy, neatness, and thoroughness of the work assigned.
Physical Requirements and Working Conditions:
- Remaining in a stationary position, often standing or sitting for prolonged periods.
- Repeating motions that may include the wrists, hands, and/or fingers.
- Must be able to provide a dedicated, secure work area.
- Must be able to provide high-speed internet access/connectivity and office setup and maintenance.
- No adverse environmental conditions expected.
Base compensation is paid hourly at $45.67 per hour (95k annualized). This role is eligible for discretionary bonus consideration.
Nonexempt employees are eligible to receive overtime pay for hours worked in excess of 40 hours in a given week, or as otherwise required by applicable state law.
Cotiviti offers team members a competitive benefits package to address a wide range of personal and family needs, including medical, dental, vision, disability, and life insurance coverage, 401(k) savings plans, paid family leave, 9 paid holidays per year, and 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti. For information about our benefits package, please refer to our Careers page.
Date of posting: 7/22/2026
Applications are assessed on a rolling basis. We anticipate that the application window will close on 9/22/2026, but the application window may change depending on the volume of applications received or close immediately if a qualified candidate is selected.
#LI-Remote
#LI-JB1
#senior
Cotiviti
DRG Validation Auditor (Clinical & Coding)
Remote
Added 3w ago5,001-10,000 employees
Job functions:
$45.67/hr
5+ yrs exp.
Associate of Science in Nursing
Full Time
Job Description
Overview:
Start date is 8/31/2026 or 10/5/2026
Responsibilities:
Nonexempt employees are eligible to receive overtime pay for hours worked in excess of 40 hours in a given week, or as otherwise required by applicable state law.
Cotiviti offers team members a competitive benefits package to address a wide range of personal and family needs, including medical, dental, vision, disability, and life insurance coverage, 401(k) savings plans, paid family leave, 9 paid holidays per year, and 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti. For information about our benefits package, please refer to our Careers page.
Date of posting: 7/22/2026
#LI-Remote
This auditing role will focus on Coding & Clinical Chart Validation for our Inpatient audits (DRG Validation). The ideal candidate for this position needs to have both a clinical (nurse) and a coding / auditing background focused on the following disciplines from a coding and billing perspective: Inpatient DRG/APR-DRG. This position is responsible for auditing inpatient claims and documenting the results of those audits, with a focus on clinical review, coding accuracy, and the appropriateness of treatment setting and services delivered.
Start date is 8/31/2026 or 10/5/2026
- Analyzes and Audits Claims. Integrates medical chart coding principles, clinical guidelines and objectivity in performance of medical audit activities. Draws on advanced ICD-10 coding expertise, clinical guidelines, and industry knowledge to substantiate conclusions. Performs work independently.
- Effectively Utilizes Audit Tools. Utilizes Cotiviti proprietary auditing systems with a high level of proficiency to make audit determinations and generate audit letters.
- Meets or Exceeds Standards/Guidelines for Productivity. Maintains production goals set by the audit operations management team.
- Meets or Exceed Standards/Guidelines for Accuracy and Quality. Achieves the expected level of accuracy and quality set by the audit for the auditing concept, for valid claim, identification and documentation (letter writing).
- Identifies New Claim Types.
- Identifies potential claims outside of the concept where additional recoveries may be available.
- Suggests and develops high quality, high value concept and or process improvement, tools, etc.
- Complete all responsibilities as outlined on annual Performance Plan.
- Complete all special projects and other duties as assigned.
- Must be able to perform duties with or without reasonable accommodation.
- Complete all responsibilities as outlined on annual Performance Plan.
- Complete all special projects and other duties as assigned.
- Must be able to perform duties with or without reasonable accommodation.
This job description is intended to describe the general nature and level of work being performed and is not to be construed as an exhaustive list of responsibilities, duties, and skills required. This job description does not constitute an employment agreement and is subject to change as the needs of Cotiviti and the requirements of the job change.
Qualifications:
Education (at least one of the following are required):
- Associate or bachelor’s degree in nursing (active /unrestricted license).
- Associate or bachelor’s degree Health Information Management (RHIA or RHIT).
- High school diploma or GED plus equivalent experience of 5+ years’ experience in claims auditing, quality assurance, or recovery auditing...ideally in a DRG / Clinical Validation Audit setting or a hospital environment.
Coding/CDI Certification (at least one of the following are required and are to be maintained as a condition of employment):
- RHIA or RHIT.
- CPC.
- Inpatient Coding Credential – CCS, CIC, CDIP or CCDS.
Experience (required):
- 5 to 7+ years of working with ICD-9/10CM, MS-DRG, AP-DRG and APR-DRG with a broad knowledge of medical claims billing/payment systems provider billing guidelines, payer reimbursement policies, medical necessity criteria and coding terminology.
- Adherence to official coding guidelines, coding clinic determinations and CMS and other regulatory compliance guidelines and mandates. Requires expert coding knowledge - DRG, APRDRG, ICD-10, CPT, HCPCS codes.
- Requires working knowledge of and applicable industry-based standards.
- Proficiency in Word, Access, Excel, TEAMS, and other applications.
- Excellent written and verbal communication skills.
Mental Requirements:
- Communicating with others to exchange information.
- Assessing the accuracy, neatness, and thoroughness of the work assigned.
Physical Requirements and Working Conditions:
- Remaining in a stationary position, often standing or sitting for prolonged periods.
- Repeating motions that may include the wrists, hands, and/or fingers.
- Must be able to provide a dedicated, secure work area.
- Must be able to provide high-speed internet access/connectivity and office setup and maintenance.
- No adverse environmental conditions expected.
Base compensation is paid hourly at $45.67 per hour (95k annualized). This role is eligible for discretionary bonus consideration.
Nonexempt employees are eligible to receive overtime pay for hours worked in excess of 40 hours in a given week, or as otherwise required by applicable state law.
Cotiviti offers team members a competitive benefits package to address a wide range of personal and family needs, including medical, dental, vision, disability, and life insurance coverage, 401(k) savings plans, paid family leave, 9 paid holidays per year, and 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti. For information about our benefits package, please refer to our Careers page.
Date of posting: 7/22/2026
Applications are assessed on a rolling basis. We anticipate that the application window will close on 9/22/2026, but the application window may change depending on the volume of applications received or close immediately if a qualified candidate is selected.
#LI-Remote
#LI-JB1
#senior
See All 7 Mid Level Clinical Auditor Jobs
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Find JobsMid Level Clinical Auditor Job Market
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Mid Level Clinical Auditor Jobs: Frequently Asked Questions
How do I get a mid level clinical auditor job?
Position your experience around audit ownership, not just participation. Highlight cases where you led a review from planning through corrective action, interpreted regulatory standards independently, and communicated findings to clinical or compliance stakeholders. Tailor your resume to the specific audit scope in each posting, whether that is HIPAA, CMS conditions, or accreditation readiness, and quantify the impact of your work wherever possible.
Which companies hire mid level clinical auditors?
Companies hiring mid level clinical auditors right now include DaVita, Waystar, and Cotiviti, based on current listings on Migrate Mate as of August 2026. At this level, hiring covers health systems, managed care organizations, hospital networks, and compliance consulting firms that need auditors who can run engagements with limited oversight.
Are there remote mid level clinical auditor jobs?
Yes, and the share is meaningful. About 75% of mid level clinical auditor openings are remote or hybrid as of August 2026, reflecting how much of the audit workflow, documentation review, chart analysis, and report writing, translates well to distributed settings. On-site roles remain common when audits require direct access to clinical staff or physical records.
How do I move up to a mid level clinical auditor role?
The progression hinges on shifting from executing tasks to owning outcomes. In your first few years, focus on deepening fluency in a specific regulatory framework, such as CMS conditions of participation, Joint Commission standards, or payer audit processes, and seek assignments where you manage a full audit cycle. Demonstrating measurable impact, such as deficiency rates reduced or audit cycle times shortened, signals readiness for mid level responsibility.
Which industries hire the most mid level clinical auditors?
Mid Level clinical auditor roles concentrate in Healthcare & Medical Services, Technology & Software, and Education, based on current listings on Migrate Mate as of August 2026. These sectors drive demand because they operate under dense regulatory and accreditation requirements that require experienced auditors who can assess compliance independently and translate findings into actionable corrective plans.