Claims Auditor: Quality & Cost Integrity

redirect-health-careers; Phoenix (AZ); On-site; USD 50,000 - 55,000; Full time

Job summary

Redirect Health in Phoenix is seeking a Dedicated Claims Auditor to oversee medical and pharmacy claims auditing for our members. You’ll evaluate payment accuracy, coding, and plan provisions to ensure 0% error rates and efficient workflows.

We value healthcare experience, strong analytical skills, and clear communication as we support our mission to make care affordable for families nationwide. Competitive salary and benefits offered.

Qualifications

• 2+ years in a dedicated claims/auditing role.
• Healthcare or customer service background preferred.
• Strong analysis, problem-solving, and communication skills.

Responsibilities

• Audit medical and pharmacy claims for payment accuracy and coding.
• Validate claims against reimbursement methodologies and plan documents.
• Review high-dollar and complex claims for billing integrity.
• Identify overpayments/underpayments and support recovery efforts.
• Suggest process improvements to reduce leakage.

Skills

Claims auditing

System analysis

Problem-solving

Communication

Interpersonal skills

Job description

Redirect Health in Phoenix is seeking a Dedicated Claims Auditor to oversee medical and pharmacy claims auditing for our members. You’ll evaluate payment accuracy, coding, and plan provisions to ensure 0% error rates and efficient workflows.

We value healthcare experience, strong analytical skills, and clear communication as we support our mission to make care affordable for families nationwide. Competitive salary and benefits offered.