Job Description

Medical Auditor – Full-Time
Date Posted: November 12, 2025
We are looking for a highly qualified Medical Auditor to join our team. You will review medical records and insurance claims to ensure medical necessity, coding accuracy, and regulatory compliance. Collaborate with insurance companies, TPAs, and doctors to identify non-conformities and provide training where needed.
Responsibilities:
Conduct medical record reviews for coding and billing accuracy.
Analyze claims data to identify trends and risks.
Develop and implement audit plans.
Educate doctors on coding and documentation requirements.
Collaborate with stakeholders to ensure compliance.
Prepare and present audit reports.
Requirements:
Medical degree from a recognized institution.
CPMA certification.
2-3 years experience in insurance companies or TPAs.
Strong knowledge of CPT, HCPCS, ICD-10, and healthcare laws (HIPAA).
Excellent analytical, communication, and problem-solving skills.
Detail-oriented with the ability to work independently or in a team.
Job Type: Full-time