Claims Auditor/Trainer

About the role

The Healthcare Claims Auditor/Trainer ensures the accuracy, compliance, and quality of claims processing across all business lines. This role conducts detailed audits, creates and delivers training programs, and steps in as operational leader when Claims Managers or Supervisors are unavailable.

Key responsibilities

• Perform comprehensive audits of healthcare claims to verify accuracy and regulatory compliance.
• Develop, update, and deliver training curricula for internal staff and external providers.
• Provide operational leadership and decision‑making support in the absence of Claims Managers or Supervisors.
• Collaborate with internal departments and external providers to uphold high standards of adjudication, customer service, and regulatory adherence.
• Monitor and report on key performance metrics related to claims processing.

Required profile

• 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 a related field preferred.
• Strong knowledge of medical terminology, coding, and regulatory guidelines such as HIPAA and CMS.
• Excellent analytical, problem‑solving, communication, and presentation abilities.

Required skills

• Medical coding
• HIPAA compliance
• CMS regulations
• Claims auditing

What we offer

• Loan Forgiveness Program
• Competitive compensation and generous paid time off
• Comprehensive 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 subsidiaries