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Claims Auditor
Posted: 04/01/2026
Job Type:
Permanent/Direct Hire
Industry: Other (HR, Admin, Mkt, Sales)
Job Number: 27222
Pay Rate: $ 60000.00 - $ 75000.00
Job Description
Claims Auditor
Location: Sarasota, FL or Orlando FL | Full-Time Onsite
Our client is seeking a detail-oriented and analytical Claims Auditor to support and enhance their internal claims audit program. This role is ideal for an experienced claims professional who thrives on evaluating processes, identifying opportunities for improvement, and ensuring compliance with regulatory standards and best practices. You'll work closely with leadership to strengthen audit quality, improve claims handling consistency, and drive operational excellence across the organization.
Key Responsibilities
- Conduct comprehensive audits of claim files to ensure compliance with internal policies, regulatory requirements, and industry standards
- Evaluate claim handling including coverage analysis, investigations, documentation, reserving, and settlement practices
- Identify compliance risks, procedural gaps, and areas for operational improvement
- Prepare detailed audit reports and clearly communicate findings and recommendations to leadership
- Analyze audit results and trends to support performance improvement initiatives
- Participate in internal and external audits, including regulatory and reinsurer reviews
- Maintain accurate audit records and ensure compliance with documentation and retention standards
- Assist with audit planning, scheduling, file selection, and quality monitoring processes
- Collaborate with Claims Leadership to implement corrective actions and improve outcomes
- Support training and continuous improvement initiatives based on audit findings
Job Requirements
Qualifications
- Bachelor's degree in Business, Insurance, Risk Management, or a related field preferred
- 5+ years of experience in P&C claims handling, claims auditing, or quality assurance
- Strong understanding of property and liability claims, including coverage analysis and policy interpretation
- Experience working with claims management systems and audit tools
- Proficiency in Microsoft 365 (Word, Excel, PowerPoint, Outlook, Teams)
- Strong analytical skills with the ability to assess complex claim files and identify trends
- Excellent written and verbal communication skills
Preferred Qualifications
- Experience handling or auditing CAT (catastrophe) claims
- Familiarity with platforms such as Guidewire, Xactimate, or similar systems
- Experience participating in regulatory audits (e.g., DOI reviews)
- Demonstrated ability to influence process improvements and operational efficiencies
- Strong attention to detail with a commitment to accuracy and compliance
- Ability to manage multiple audits and deadlines in a fast-paced environment
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