Medical Claims Auditor – Precision & Impact

Southwest Service Administrators Inc; United States; On-site; USD 50,000 - 80,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Short-Term Disability

401K with company match

Long Term Disability & Life/AD&D

Paid Time Off

Job summary

Southwest Service Administrators is seeking a Claims Auditor to perform audits on medical and dental claims and prepare concise management reports. The role supports the team manager by maintaining documentation and ensuring accuracy across product lines.

The ideal candidate has 3 years of claims analysis experience, strong medical knowledge, and excellent attention to detail. This position emphasizes independent work, collaborative teamwork, and participation in ongoing training.

Qualifications

• High School Diploma or GED required.
• Three (3) years recent experience analyzing medical claims.
• Proficient in medical terminology, CPT/ICD codes, and related claim forms.
• Strong attention to detail with accurate data interpretation.
• Good written and verbal communication skills.

Responsibilities

• Audit medical and/or dental claim activities and prepare reports for management.
• Research processing issues to determine origin and resolution.
• Maintain understanding of plan designs, policies, and compliance regulations.
• Assist in testing system functionality during upgrades and implementations.
• Collaborate with team members and participate in meetings and trainings.

Skills

Medical terminology

CPT Codes

ICD 9/10

Attention to detail

Written communication

Time management

Independent work

Education

High School Diploma/GED

Tools

MS Excel

MS Word

Job description

Southwest Service Administrators is seeking a Claims Auditor to perform audits on medical and dental claims and prepare concise management reports. The role supports the team manager by maintaining documentation and ensuring accuracy across product lines.

The ideal candidate has 3 years of claims analysis experience, strong medical knowledge, and excellent attention to detail. This position emphasizes independent work, collaborative teamwork, and participation in ongoing training.