Coding Investigator Auditor

Health Care Service Corporation

Coding Investigator Auditor responsible for validating claims for health services. Performing reviews, research, and documentation while coordinating with various departments.

Posted 5/6/2026full-timeRemote • Illinois, Montana, New Mexico, Oklahoma, Texas • 🇺🇸 United StatesMid-LevelSenior💰 $55,900 - $123,500 per yearWebsite

About the role

Key responsibilities & impact

Performing clinical, billing, coding and lowest cost setting reviews for services pre and post payment
Utilizing medical, contractual, legislative, policy, and other information to validate claims submitted and billed
Conducting research and preparing documentation of findings
Consulting with medical directors as needed
Coordinating with all departments involved in each case required
Performing itemized bill review for high dollar claims and reimbursements

Requirements

What you’ll need

Bachelor Degree
One year of business experience, law enforcement experience, or regulatory agency experience may substitute for each year of college
Certified Coding Certification, or acquire within 24 months of hire
3 years experience in claims processing operations and reporting systems, including 2 years experience in auditing or developing computer system reports
Knowledge of accreditation, i.e., URAC, NCQA standards and health insurance legislation
Awareness of claims processes and claims processing systems
PC proficiency to include Microsoft Word and Excel and health insurance databases
Verbal and written communication skills with ability to communicate to physicians, members and providers and compose and explain document findings
Organizational skills and prioritization skills

Benefits

Comp & perks

Health and wellness benefits
401(k) savings plan
Pension plan
Paid time off
Paid parental leave
Disability insurance
Supplemental life insurance
Employee assistance program
Paid holidays
Tuition reimbursement

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools

codingclaims processingauditingreporting systemsitemized bill reviewreimbursementsresearchdocumentation

Soft Skills

verbal communicationwritten communicationorganizational skillsprioritization skills

Certifications

Certified Coding Certification