Healthcare Claims Auditor — Quality & Cost-Saving Impact

Rippling, Inc.; Phoenix (AZ); On-site; USD 50,000 - 55,000; Full time

Benefits offered by this job

Free healthcare

Paid time off

401(k)

Job summary

Redirect Health is seeking a Dedicated Claims Auditor to oversee and ensure comprehensive medical and pharmacy claims auditing practices for our members. This is an opportunity to make a direct impact, examine and improve workflows, and support the Claims Management team in sustaining our vision of 0% Error Rates — all while helping people access the care they need.

We’re looking for a healthcare professional who thrives in a fast-paced, adaptable environment and is passionate about delivering

Qualifications

• Experience: 2+ years in a dedicated claims and/or auditing role, preferably in healthcare or customer service.
• Skills: Strong system and rules analysis, problem-solving, and decision-making abilities. Excellent communication and interpersonal skills.

Responsibilities

• Audit medical and pharmacy claims for payment accuracy, coding appropriateness, and plan provisions.
• Validate claims against internal reimbursement methodologies, contracts, fee schedules, and plan documents.
• Review high-dollar, complex, and outlier claims for billing accuracy and reimbursement integrity.
• Identify claim overpayments, underpayments, and recovery opportunities.

Skills

Claims auditing

Healthcare/insurance knowledge

Analytical thinking

Communication skills

Job description

Redirect Health is seeking a Dedicated Claims Auditor to oversee and ensure comprehensive medical and pharmacy claims auditing practices for our members. This is an opportunity to make a direct impact, examine and improve workflows, and support the Claims Management team in sustaining our vision of 0% Error Rates — all while helping people access the care they need.

We’re looking for a healthcare professional who thrives in a fast-paced, adaptable environment and is passionate about delivering