Claims Auditor

Job overview

The Claims Auditor role is onsite in Miami, FL, with compensation not specified. Independent Living Systems and its affiliated health plans work to promote quality of life and maximize independence for vulnerable populations. The auditor reviews healthcare claims for accuracy, compliance, and adherence to organizational policies. By identifying errors, discrepancies, potential fraud, and process improvements, the role supports accountable claims operations and the organization’s financial integrity.

What you'll do

• Audit healthcare claims for accuracy, regulatory compliance, and adherence to organizational policies
• analyze claim data and documentation for errors, inconsistencies, or potential fraud
• prepare audit reports with findings, recommendations, and corrective actions
• collaborate with claims teams and healthcare providers to resolve discrepancies and improve processes
• stay current on healthcare regulations and industry practices
• support internal and external audits with documentation and insights.

What we're looking for

Skills & competencies

claims auditor

miami fl

independent living systems

healthcare claims

claims auditing

compliance

hipaa

cms guidelines

fraud detection

audit reporting

process improvement

excel data analysis

Work arrangement

• Weekend coverage required

Why this role

Requires a bachelor’s degree in health administration or related field and at least two years of claims auditing, healthcare compliance, or similar experience; relevant experience may substitute for education year for year. CIA, CPC, or CHA certification is preferred.

About the employer

Independent Living Systems is hiring for this role. Industry: All Other Insurance Related Activities. Sector: 52.