Medical Claims Auditor

Job Title: Medical Claims Auditor - RN AuditorLocation: Massachusetts – 90% RemoteJob Type: 1 Year Contract - Potential for Perm HireHours: 40 hours per weekStart Date: December 1, 2025Job DescriptionWe are seeking a qualified Auditor with healthcare experience to support Program Integrity activities for a state healthcare program. This role focuses on conducting both desk and onsite audits of healthcare providers to ensure compliance with contractual standards and regulatory requirements. ResponsibilitiesConduct audits (onsite and desk-based) of healthcare providers in alignment with state program guidelinesTravel locally as required to perform onsite audits (1-4 times per month)Evaluate claims and provider documentation for compliance and accuracyCollaborate with internal audit teams and leadership to maintain audit quality standardsDocument findings and present audit outcomes clearly and effectivelyUse Microsoft Office tools to manage reports, track audits, and communicate outcomesAdhere to defined Service Level Agreements (SLAs) for audit completion and reporting

Salary : $45 - $52