Remote Claims Auditor Jobs
Remote claims auditor jobs are in active demand across the U.S., with remote-first insurers, distributed healthcare networks, and third-party administrators hiring on a rolling basis. Employers hiring remotely right now include Pie Insurance, Highmark Health, and SCAN Health Plan. Scan the live roles below and apply to whichever ones fit.
Find Remote Claims Auditor JobsOverview
Showing 5 of 7+ Remote Claims Auditor jobs
Founded in 1977 as the Senior Care Action Network, SCAN began with a simple but radical idea: that older adults deserve to stay healthy and independent. That belief was championed by a group of community activists we still honor today as the “12 Angry Seniors.” Their mission continues to guide everything we do.
Today, SCAN is a nonprofit health organization serving more than 500,000 people across Arizona, California, Nevada, New Mexico, Texas, and Washington, with over $8 billion in annual revenue. With nearly five decades of experience, we have built a distinctive, values-driven platform dedicated to improving care for older adults.
Our work spans Medicare Advantage, fully integrated care models, primary care, care for the most medically and socially complex populations, and next-generation care delivery models. Across all of this, we are united by a shared commitment: combining compassion with discipline, innovation with stewardship, and growth with integrity.
At SCAN, we believe scale should strengthen—not dilute—our mission. We are building the future of care for older adults, grounded in purpose, accountability, and respect for the people and communities we serve.
The Job
The Claims Auditor will perform various audits of claims payments and denials to ensure accuracy.
You Will
- Conduct pre-pay and post-pay audits to ensure accurate claims payments and denials.
- Ensure regulatory compliance and overall quality and efficiency by utilizing strong working knowledge of claims processing standards.
- Work assigned cases through SCANs workflow system, and applies correct status attributes to track and trend issues.
- Notate cases/audits with required detail to ensure that others understand status of case/audit and final resolutions.
- Work closely with other units within the Claims Department to ensure processing errors are reviewed and corrected prior to final payment.
- Follow policies and procedures in order to maintain efficient and compliant operations; communicate suggestions for improvement and efficiencies to management; identify and report problems with workflows following proper departmental procedures; actively participate in departmental staff meetings and training sessions.
- Follow all appropriate Federal and State regulatory requirements and guidelines applicable to SCAN Health Plan operations or as documented in company policies and procedures.
- Provide a high level of customer service to internal customers by consistently meeting and/or exceeding team expectations including but not limited to quality, productivity and attendance.
- Escalate appropriate claims/audit issues to management as required and follow departmental/organizational policies and procedures.
- Maintain required levels of production and quality standards as established by management.
- Participate in and supports ad-hoc audits as needed. Contribute to overall department success by participating in department initiatives, effective communication and collaboration with all members of the SCAN team through knowledge and idea sharing, take ownership to identify and report issues to appropriate management staff for resolution and work actively with the SCAN team to improve the support to our Members and Providers.
- Contribute to team effort by accomplishing related results as needed.
- We seek Rebels who are curious about AI and its power to transform how we operate and serve our members.
- Actively support the achievement of SCAN’s Vision and Goals.
- Other duties as assigned.
Your Qualifications
- Associate’s degree preferred or equivalent experience
- 3+ years complex claims processing and/or auditing experience with a health plan, healthcare, or managed care organization.
- Proficient in processing/auditing claims for Medicare and Medicaid plans.
- Strong knowledge of CMS requirements regarding claims processing.
- Working knowledge of DOFR (Division of Financial Responsibility), COB (Coordination of Benefits).
- Current experience in both Institutional and Professional claim payment.
- Knowledge of standard coding and reference materials used in a claim setting, such as CPT4, ICD9, ICD10, DRG and HCPCS.Completion of health insurance training and medical terminology or equivalent knowledge through on-the-job training and experience.
- Knowledge of health care benefit structures and insurance procedures, as they exist in a Managed Care environment. Knowledge of automated claims processing systems, preferably IKA, and QNXT.
What’s in it for you?
- Base wage range: $25.38 to $36.76 per hour
- Work Mode: Remote
- Annual bonus program
- Robust Wellness Program
- Generous paid-time-off (PTO)
- Eleven paid holidays per year, plus 1 additional floating holiday, plus 1 birthday holiday
- Excellent 401(k) Retirement Saving Plan with employer match and contribution
- Robust employee recognition program
- Tuition reimbursement
- An opportunity to become part of a team that makes a difference to our members and our community every day!
We're always looking for talented people to join our team! Qualified applicants are encouraged to apply now!
At SCAN we believe that it is our business to improve the state of our world. Each of us has a responsibility to drive Equality in our communities and workplaces. We are committed to creating a workforce that reflects our community through inclusive programs and initiatives such as equal pay, employee resource groups, inclusive benefits, and more.
SCAN is proud to be an Equal Employment Opportunity and Affirmative Action workplace. Individuals seeking employment will receive consideration for employment without regard to race, color, national origin, religion, age, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender perception or identity, age, marital status, disability, protected veteran status or any other status protected by law. A background check is required.
#LI-MS1
#LI-Remote
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)
Founded in 1977 as the Senior Care Action Network, SCAN began with a simple but radical idea: that older adults deserve to stay healthy and independent. That belief was championed by a group of community activists we still honor today as the “12 Angry Seniors.” Their mission continues to guide everything we do.
Today, SCAN is a nonprofit health organization serving more than 500,000 people across Arizona, California, Nevada, New Mexico, Texas, and Washington, with over $8 billion in annual revenue. With nearly five decades of experience, we have built a distinctive, values-driven platform dedicated to improving care for older adults.
Our work spans Medicare Advantage, fully integrated care models, primary care, care for the most medically and socially complex populations, and next-generation care delivery models. Across all of this, we are united by a shared commitment: combining compassion with discipline, innovation with stewardship, and growth with integrity.
At SCAN, we believe scale should strengthen—not dilute—our mission. We are building the future of care for older adults, grounded in purpose, accountability, and respect for the people and communities we serve.
The Job
The Claims Auditor will perform various audits of claims payments and denials to ensure accuracy.
You Will
- Conduct pre-pay and post-pay audits to ensure accurate claims payments and denials.
- Ensure regulatory compliance and overall quality and efficiency by utilizing strong working knowledge of claims processing standards.
- Work assigned cases through SCANs workflow system, and applies correct status attributes to track and trend issues.
- Notate cases/audits with required detail to ensure that others understand status of case/audit and final resolutions.
- Work closely with other units within the Claims Department to ensure processing errors are reviewed and corrected prior to final payment.
- Follow policies and procedures in order to maintain efficient and compliant operations; communicate suggestions for improvement and efficiencies to management; identify and report problems with workflows following proper departmental procedures; actively participate in departmental staff meetings and training sessions.
- Follow all appropriate Federal and State regulatory requirements and guidelines applicable to SCAN Health Plan operations or as documented in company policies and procedures.
- Provide a high level of customer service to internal customers by consistently meeting and/or exceeding team expectations including but not limited to quality, productivity and attendance.
- Escalate appropriate claims/audit issues to management as required and follow departmental/organizational policies and procedures.
- Maintain required levels of production and quality standards as established by management.
- Participate in and supports ad-hoc audits as needed. Contribute to overall department success by participating in department initiatives, effective communication and collaboration with all members of the SCAN team through knowledge and idea sharing, take ownership to identify and report issues to appropriate management staff for resolution and work actively with the SCAN team to improve the support to our Members and Providers.
- Contribute to team effort by accomplishing related results as needed.
- We seek Rebels who are curious about AI and its power to transform how we operate and serve our members.
- Actively support the achievement of SCAN’s Vision and Goals.
- Other duties as assigned.
Your Qualifications
- Associate’s degree preferred or equivalent experience
- 3+ years complex claims processing and/or auditing experience with a health plan, healthcare, or managed care organization.
- Proficient in processing/auditing claims for Medicare and Medicaid plans.
- Strong knowledge of CMS requirements regarding claims processing.
- Working knowledge of DOFR (Division of Financial Responsibility), COB (Coordination of Benefits).
- Current experience in both Institutional and Professional claim payment.
- Knowledge of standard coding and reference materials used in a claim setting, such as CPT4, ICD9, ICD10, DRG and HCPCS.Completion of health insurance training and medical terminology or equivalent knowledge through on-the-job training and experience.
- Knowledge of health care benefit structures and insurance procedures, as they exist in a Managed Care environment. Knowledge of automated claims processing systems, preferably IKA, and QNXT.
What’s in it for you?
- Base wage range: $25.38 to $36.76 per hour
- Work Mode: Remote
- Annual bonus program
- Robust Wellness Program
- Generous paid-time-off (PTO)
- Eleven paid holidays per year, plus 1 additional floating holiday, plus 1 birthday holiday
- Excellent 401(k) Retirement Saving Plan with employer match and contribution
- Robust employee recognition program
- Tuition reimbursement
- An opportunity to become part of a team that makes a difference to our members and our community every day!
We're always looking for talented people to join our team! Qualified applicants are encouraged to apply now!
At SCAN we believe that it is our business to improve the state of our world. Each of us has a responsibility to drive Equality in our communities and workplaces. We are committed to creating a workforce that reflects our community through inclusive programs and initiatives such as equal pay, employee resource groups, inclusive benefits, and more.
SCAN is proud to be an Equal Employment Opportunity and Affirmative Action workplace. Individuals seeking employment will receive consideration for employment without regard to race, color, national origin, religion, age, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender perception or identity, age, marital status, disability, protected veteran status or any other status protected by law. A background check is required.
#LI-MS1
#LI-Remote
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)
See All 7 Remote Claims Auditor Jobs
Find roles that match your experience and apply in just a few clicks.
Find Remote Claims Auditor JobsRemote Claims Auditor Job Market
Who's Hiring
Top Industries Hiring
- Healthcare & Medical Services
What Employers Look For
The qualifications that appear most often in remote claims auditor jobs.
- Three or more years of experience reviewing medical, workers' compensation, or property claims
- Knowledge of ICD-10, CPT, and HCPCS coding systems for clinical audit roles
- Proficiency with claims management platforms and audit documentation tools
- Professional certification such as CPC, CRC, CFE, or AHFI preferred or required
- Strong understanding of payer contracts, coverage policies, and regulatory compliance standards
- Associate or bachelor's degree in health information management, business, or a related field
Tips for Your Remote Claims Auditor Job Search
Apply early to remote roles that fit
Migrate Mate lists remote claims auditor openings from across the U.S. in one place, so you can find roles that match your background and apply directly without sorting through unrelated postings.
Demonstrate async communication skills upfront
Remote claims auditor employers move fast on candidates who show clear written communication before the interview. Write your cover letter like a memo: direct findings, reasoning, and a recommended action, mirroring how you'd document an actual audit.
Show your claims software proficiency explicitly
Remote hiring managers cannot watch you work, so name the specific claims management platforms, coding systems, and audit tools you have used. List them in your resume with the context, such as the claim type or volume, to give employers something concrete to evaluate.
Prepare for remote audit simulations in interviews
Many remote claims auditor interviews include a practical exercise where you review a sample claim or audit file and document your findings. Practice writing concise, structured audit summaries in advance so you can produce them cleanly under a time limit.
Remote Claims Auditor Jobs: Frequently Asked Questions
How do I get a remote claims auditor job?
Target companies that already operate distributed teams, such as remote-first third-party administrators, insurers with regional claim centers, and healthcare managed care organizations. Remote employers screen heavily for self-direction, precise written communication, and familiarity with claims management software. Candidates who can demonstrate independent case resolution, attention to regulatory compliance, and comfort with async workflows consistently stand out from the field.
Which companies hire remote claims auditors?
Companies hiring remote claims auditors right now include Pie Insurance, Highmark Health, and SCAN Health Plan, based on current remote listings on Migrate Mate as of November 2026. Remote-first insurers, distributed third-party administrators, and managed care organizations across insurance, healthcare, and financial services make up the bulk of these openings.
Can you get a remote claims auditor job with no experience?
Yes, but remote entry-level roles are harder to land because employers expect you to work independently from day one with minimal oversight. Remote-first third-party administrators and smaller managed care organizations are more likely to hire entry-level candidates. Showing completed coursework in medical billing or insurance fundamentals, volunteer audit work, or a demonstrated ability to manage detailed documentation independently can open the door.
Do you need a degree for remote claims auditor jobs?
Not always. Many remote employers weigh hands-on claims review experience, familiarity with coding systems such as ICD and CPT, and demonstrated accuracy in audit workflows as heavily as a formal degree. Certifications in healthcare compliance or claims management can substitute effectively, particularly at remote-first firms where verifiable skills and output matter more than credentials.
Which industries hire the most remote claims auditors?
The sectors hiring the most remote claims auditors are Healthcare & Medical Services, based on current remote listings on Migrate Mate as of November 2026. These industries rely on distributed teams to review high volumes of claims across multiple states without centralizing staff in a single office.
See All 7 Remote Claims Auditor Jobs
Find roles that match your experience and apply in just a few clicks.
Find Remote Claims Auditor Jobs