Job Description

Job Title: Medical Claims Auditor

Job Overview:
We are seeking a dedicated and detail-oriented Medical Claims Auditor to join our client and play a vital role in supporting claims operations. This remote contract position (EST or CST time zone) focuses on reviewing, auditing, and managing medical stop loss claim submissions while ensuring accuracy, compliance, and timely processing. The ideal candidate will bring strong analytical skills, a solid background in claims administration, and the ability to collaborate effectively across teams.

Compensation:

• $23–$26/hour

Work Schedule:

• Monday–Friday, standard business hours in your time zone

Key Responsibilities of the Medical Claims Auditor:

• Review and audit medical stop loss claim submissions for accuracy and compliance with plan documents, stop loss contracts, and carrier standards 
• Facilitate financing of approved claims and collaborate with finance teams as needed
• Issue denials and pend claims appropriately, escalating complex cases to clinical or management review
• Maintain thorough and accurate claim documentation 
• Prepare periodic reporting for internal and external stakeholders
• Provide insights on claim projections and development
• Identify, document, and escalate trends in claims for quality improvement
• Conduct self-audits and maintain high accuracy standards to meet turnaround time and performance metrics
• Offer feedback and collaborate with team members to streamline and enhance processes

Qualifications and Skills for the Medical Claims Auditor:

• High School Diploma or GED required; Bachelor’s degree in Medical Billing and Coding or a related field preferred
• 5+ years of experience in medical claims administration (carrier or provider); knowledge of Third Party Administration functions a plus
• Strong knowledge of medical terminology
• Proficiency in Microsoft Office and related software tools
• Excellent organizational, problem-solving, and analytical skills with a strong attention to detail

Why Join Us?
This is an excellent opportunity to apply your expertise in medical claims auditing while working in a collaborative and supportive remote environment. You’ll play a key role in ensuring accuracy, compliance, and quality within the claims process—all while enjoying the flexibility of remote work and the chance to make a meaningful impact.

About Us:
Contemporary Staffing Solutions (CSS) is a trusted leader in providing contract, temporary, temp-to-hire, and direct hire staffing solutions. With decades of experience, we’ve grown from a staffing agency to a nationwide provider of workforce management solutions. Our niche recruitment expertise spans Accounting & Finance, Call Center & Office Support, Human Resources, Sales & Marketing, and Information Technology.

Explore more about CSS and how we connect great talent with exceptional opportunities by visiting www.ContemporaryStaffing.com.

Job Tags

Contract work, Temporary work, Work at office, Remote work, Monday to Friday,

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