Claims Auditor: Precision in Healthcare Compliance

Independent Living Systems, llc; Miami (FL); On-site; USD 65,000 - 85,000; Full time

Job summary

Independent Living Systems (ILS) is seeking a Claims Auditor in Miami, FL to ensure the accuracy, compliance, and integrity of health care claims by auditing submissions against regulatory standards and internal policies.

The role involves collaborating with claims processors, providers, and compliance teams to identify discrepancies, drive improvements, and support transparent claims operations, while staying current on healthcare regulations.

Qualifications

• Bachelor’s degree in Health Administration or related field.
• At least 2 years of experience in claims auditing or healthcare compliance.
• Strong knowledge of healthcare claims processes, HIPAA and CMS guidelines.
• Proficiency in audit software and Excel for data analysis.

Responsibilities

• Conduct detailed audits of healthcare claims for accuracy and regulatory compliance.
• Analyze claim data to identify errors, inconsistencies, or potential fraud.
• Prepare audit reports with findings and corrective actions.
• Collaborate with claims teams and providers to resolve discrepancies.
• Stay updated on healthcare regulations and best practices.

Skills

Attention to detail

Data analysis

Communication skills

Education

Bachelor’s degree in Health Administration

Tools

Audit software

Microsoft Excel

Job description

Independent Living Systems (ILS) is seeking a Claims Auditor in Miami, FL to ensure the accuracy, compliance, and integrity of health care claims by auditing submissions against regulatory standards and internal policies.

The role involves collaborating with claims processors, providers, and compliance teams to identify discrepancies, drive improvements, and support transparent claims operations, while staying current on healthcare regulations.