Remote Insurance Claims Auditor
Description
Remote Insurance Claims Auditor
Position Overview
We’re seeking a detail-obsessed and tech-savvy Remote Insurance Claims Auditor to join our dynamic auditing team. This opportunity is ideal for someone who excels in a data-driven remote environment and is passionate about leveraging auditing tools, digital workflows, and intelligent systems to ensure insurance claim accuracy and compliance. You’ll work entirely virtually, applying analytical rigor to policy claims, reducing errors, and driving quality assurance across multi-line insurance products.
Key Responsibilities
Audit Execution and Compliance
- Conduct comprehensive audits of health, life, and property insurance claims with a keen eye for discrepancies.
- Verify claims for accuracy, eligibility, and adherence to internal protocols and external regulations.
- Review payout justifications, supporting documentation, and claim notes.
- Identify trends, red flags, or system inefficiencies across processed claims.
Reporting and Analytics
- Generate audit reports and dashboards using BI tools such as Power BI and Tableau.
- Provide data-backed recommendations to refine underwriting and claims practices.
- Translate raw claims data into actionable quality control insights.
- Track and monitor audit outcomes to inform ongoing risk mitigation strategies.
Collaboration and Knowledge Sharing
- Partner with claims processors, adjusters, and compliance teams to share insights.
- Help train new team members on audit protocols and tech platforms.
- Act as a remote knowledge base for policy interpretation and best practices.
Work Environment and Culture
Our remote-first structure is supported by advanced digital platforms, empowering you to work independently while staying connected through agile communication tools like Slack, Zoom, and Jira. You’ll experience a culture where analytical minds are encouraged to challenge conventions, propose improvements, and drive measurable results—all within a flexible virtual workspace that values autonomy and precision.
Tools and Technologies
Claims and Audit Platforms
- Guidewire, Duck Creek, ClaimCenter
- SAS, ACL Analytics, AuditBoard
Data Analysis Tools
- Tableau, Power BI, Excel Pivot Tables
Collaboration and Workflow
- Microsoft Teams, Zoom, Jira, Slack
- Google Workspace, SharePoint
These technologies streamline workflows, enhance validations, and provide centralized access to audit logs.
Qualifications and Skills
Essential Qualifications
- Bachelor’s degree in Accounting, Insurance, Finance, or a related field
- Minimum 3 years of experience in insurance claims auditing (remote or onsite)
- Deep knowledge of claims lifecycle, insurance regulations, and auditing standards
- Familiarity with ICD, CPT, and HCPCS codes for healthcare claims
- High proficiency in auditing software and BI tools
Preferred Attributes
- Strong pattern recognition and investigative thinking
- Comfort working with large datasets in cloud environments
- Experience in agile work settings or virtual-first teams
- Detail-oriented with high accountability and follow-through
Why Join Us
You’ll be part of a mission-driven auditing team that values precision, integrity, and innovation. We don’t just review claims—we shape the digital backbone of tomorrow’s insurance practices. Our claims auditors play a key role in elevating trust and accuracy within the insurance industry. If you have an eye for numbers and a passion for process improvement, this is your opportunity to contribute to something impactful.
Growth and Development
As a Remote Insurance Claims Auditor, you’ll enjoy continuous opportunities for skill expansion through:
Professional Development Opportunities
- Certifications in compliance and insurance auditing
- Access to internal analytics and AI training modules
- Mentorship from seasoned audit leaders
- Cross-functional exposure to underwriting, compliance, and tech integration
Compensation and Benefits
Salary and Financial Perks
- Annual Salary: $56,202 (USD)
- 401(k) with employer match
- Equipment reimbursement and home office stipends
Health and Wellness
- Comprehensive health, dental, and vision plans
- Virtual wellness programs and mental health resources
Flexibility and Support
- Fully remote position with schedule flexibility
- Paid training and career development resources
Call to Action: Ready to Audit Smarter?
We'd love to meet you if you're driven by accuracy, guided by data, and inspired by innovation. Join a tech-forward insurance team where your analytical mindset and auditing expertise will help redefine claim integrity in the digital age.
Apply now to be the eyes behind the numbers.