UCLA Health

Claims Quality Auditor

UCLA Health  •  $62.64/hr  •  Remote  •  15 hours ago
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Job Description


General Information

Work Location: Los Angeles, CA, USA

Onsite or Remote

Flexible Hybrid

Work Schedule

Monday - Friday, 8:00am - 4:30pm PST

Posted Date

07/02/2026
Salary Range $31.51 - 62.64 Hourly

Employment Type

2 - Staff: Career

Duration

N/A

Job #

31617


Primary Duties and Responsibilities

Take on an important role within a world-class health organization. Provide specialized expertise that enables the efficient operation of a complex health system. Take your career to the next level. You can do all this and more at UCLA Health.

The Claims Quality Auditor will be responsible for the daily audit of all examiners assigned to the auditor. You will review claims (paid, pending, and denied) for accuracy, appropriate application of benefits, authorization for services, contract interpretation, Division of Financial Responsibility (DOFR), and application/compliance with policies and procedures. You will:

  • Research over and under-payment inquiries/appeals
  • Compile and maintain statistical data consistent
  • Maintain departmental production and quality standards
Salary Range: $31.51 - $62.64 Hourly


Job Qualifications

We’re seeking a self-motivated, detail-oriented, deadline-driven individual with:

  • High school diploma, GED or equivalent
  • Four or more years of medical claims payment experience in an HMO environment
  • Experience with CPT-4, ICD-9CM, RBRVS, ASA, and HCPCS
  • Understanding of Medicare Guidelines and COB
  • Knowledge of medical terminology
  • Experience in benefit determination and claims adjudication
  • Ability to accurately key 6,000-8,000 keystrokes or type 40-50 WPM
  • Understanding of professional and facility reimbursement methodologies
  • Strong organizational skills
  • Computer proficiency with Microsoft Office
  • Knowledge of claims adjudication systems
  • Flexibility and adaptability

As a condition of employment
, the final candidate who accepts an offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; or have filed an appeal of a finding of substantiated misconduct with a previous employer.

Current/former UC employees are subject to a personnel file review.
UCLA Health

About UCLA Health

For more than half a century, UCLA Health has provided the best in healthcare and the latest in medical technology to the people of Los Angeles and throughout the world.

Comprised of Ronald Reagan UCLA Medical Center, UCLA Medical Center Santa Monica, Resnick Neuropsychiatric Hospital at UCLA, UCLA Mattel Children's Hospital, UCLA West Valley Medical Center and the UCLA Medical Group with its wide-reaching system of primary-care and specialty-care offices throughout the region, UCLA Health is among the most comprehensive and advanced healthcare systems in the world.

Our physicians are world leaders in the diagnosis and treatment of complex illnesses, and our hospitals are among the best in the country. Consistently ranked one of the top ten hospitals in the nation and the best medical center in the western United States by U.S. News & World Report, Ronald Reagan UCLA Medical Center is at the cutting edge of biomedical research, and our doctors and scientists are leaders in performing pioneering work across an astounding range of disciplines, from organ transplantation and cardiac surgery to neurosurgery and cancer treatment, and bringing the latest discoveries to virtually every field of medicine.

Industry
Healthcare & Social Services
Company Size
10,000+ employees
Headquarters
Los Angeles, CA
Year Founded
1955
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