Medical Claims Auditor

Clover Health(22 days ago)

RemoteFull TimeJunior$90,000 - $110,000Special Investigation Unit

About this role

Clover is seeking a Medical Claims Auditor to join its Special Investigation Unit, which focuses on healthcare fraud, waste, and abuse. The role involves reviewing and auditing healthcare claims, particularly Medicare coding, to support compliance and detect fraudulent activity. It offers an opportunity to work in a fast-growing healthcare technology environment with a focus on professional development and team collaboration.

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Required Skills

CMS Regulations
Medicare
Coding
Audit
Claims Systems
Healthcare Insurance
Data Infrastructure
Communication
Critical Thinking

About Clover Health

cloverhealth.com

Clover Health is a Medicare Advantage provider offering HMO and PPO plans—many with $0 monthly premiums—bundling expanded benefits like dental, vision, and hearing. Headquartered in Jersey City, NJ, the company serves Medicare beneficiaries across multiple U.S. markets. Clover emphasizes a technology- and data-driven approach to care management, aiming to support providers, coordinate primary care, and improve member outcomes. It positions itself as a member-focused alternative designed to lower costs and simplify access to preventive and routine services.

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