Claims Auditor/Trainer

Providers; Reno (NV); On-site; USD 60,000 - 80,000; Full time

Benefits offered by this job

Loan Forgiveness Program

Challenging and rewarding work environment

Competitive Compensation & Generous Paid Time Off

Excellent Medical, Dental, Vision and Prescription Drug Plans

401(K) with company match and discounted stock plan

Career development opportunities

Job summary

Providers is seeking a Healthcare Claims Auditor/Trainer responsible for ensuring the accuracy, compliance, and quality of claims processing. This role involves auditing, developing training programs, and providing leadership in the absence of Claims Managers.

The ideal candidate has 3-5 years of experience in healthcare claims, strong knowledge of medical terminology, and effective training skills. Benefits include a loan forgiveness program, competitive compensation, and excellent medical plans.

Qualifications

• 3–5 years of experience in healthcare claims processing, auditing, or training.
• Strong knowledge of medical terminology, coding, and regulatory guidelines (HIPAA, CMS).
• Experience with Medicare claims processing and compliance required.

Responsibilities

• Ensure accuracy, compliance, and quality of claims processing.
• Perform detailed audits and provide operational leadership.
• Develop and deliver training programs.

Skills

Healthcare claims processing

Auditing

Training

Analytical skills

Communication skills

Education

High school diploma or equivalent

Associate or Bachelor's degree in healthcare administration, business, or related field

Tools

Claims processing systems

Microsoft Office Suite

QNXT system

Job description

Responsibilities

Prominence Health is a value-based care organization bridging the gap between affiliated health systems and independent providers, building trust and collaboration between the two. Prominence Health creates value for populations and providers to strengthen integrated partnership, advance market opportunities, and improve outcomes for our patients and members. Founded in 1993, Prominence Health started as a health maintenance organization (HMO) and was acquired by a subsidiary of Universal Health Services, Inc. (UHS) in 2014. Prominence Health serves members, physicians, and health systems across Medicare, Medicare Advantage, Accountable Care Organizations, and commercial payer partnerships. Prominence Health is committed to transforming healthcare delivery by improving health outcomes while controlling costs and enhancing the patient experience.

Job Summary: The Healthcare Claims Auditor/Trainer is responsible for ensuring the accuracy, compliance, and quality of claims processing across all lines of business. This role performs detailed audits, develops and delivers training programs, and provides operational leadership in the absence of Claims Managers or Supervisors. The position collaborates with internal departments and external providers to maintain high standards of adjudication, customer service, and regulatory compliance.

Benefit Highlights

• Loan Forgiveness Program
• Challenging and rewarding work environment
• Competitive Compensation & Generous Paid Time Off
• Excellent Medical, Dental, Vision and Prescription Drug Plans
• 401(K) with company match and discounted stock plan
• SoFi Student Loan Refinancing Program
• Career development opportunities within UHS and its 300+ Subsidiaries! More information is available on our Benefits Guest Website: benefits.uhsguest.com

Qualifications

• Minimum 3–5 years of experience in healthcare claims processing, auditing, or training.
• High school diploma or equivalent required; Associate or Bachelor’s degree in healthcare administration, business, or related field preferred.
• Strong knowledge of medical terminology, coding, and regulatory guidelines (HIPAA, CMS).
• Excellent analytical and problem‑solving abilities.
• Strong communication and presentation skills for effective training delivery.
• Proficiency in claims processing systems and Microsoft Office Suite.
• Experience with Medicare claims processing and compliance required.
• QNXT system experience highly preferred.

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

We believe that diversity and inclusion among our teammates is critical to our success.