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Cms Auditor Jobs (NOW HIRING)

ClinDCast LLC

Risk Adjustment Coding Auditor

Albany, NY · Remote

$30 - $35/hr

We are seeking a Risk Adjustment Coding Auditor with 8+ years of experience to support first- and second-pass audits for CMS RADV (Risk Adjustment Data Validation) projects. The ideal candidate must ...

ClinDCast LLC

Risk Adjustment Coding Auditor

Albany, NY · On-site

$27 - $30.75/hr

We are seeking a Risk Adjustment Coding Auditor with 8+ years of experience to support first- and second-pass audits for CMS RADV (Risk Adjustment Data Validation) projects. The ideal candidate must ...

Alan B. Miller Medical Center

HIM Coding Auditor

Wayne, PA · On-site

$24.75 - $28/hr

... per CMS Local Coverage Determination (LCD). Applies working knowledge of medical terminology ... Auditing experience required. * AAPC CPC Certification required. * Healthcare (professional ...

Noridian Healthcare Solutions

Provider Auditor II

Fargo, ND · On-site +1

$52K - $78K/yr

Mentors Auditor I and Auditor II level staff by training, coaching, and providing constructive and ... CMS Access Compliance and Regulation Contingency Statement Some positions require compliance with ...

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$76.3K

$121.5K

How much do cms auditor jobs pay per year?

As of Aug 12, 2026, the average yearly pay for cms auditor in the United States is $76,256.00, according to ZipRecruiter salary data. Most workers in this role earn between $53,500.00 and $98,500.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a CMS auditor?

To thrive as a CMS Auditor, you need expertise in healthcare compliance, detailed knowledge of Centers for Medicare & Medicaid Services (CMS) regulations, and a background in auditing or healthcare administration. Familiarity with claims review software, electronic health records (EHR) systems, and relevant certifications such as Certified Professional Medical Auditor (CPMA) or Certified Internal Auditor (CIA) is highly valued. Strong analytical thinking, meticulous attention to detail, and effective communication skills are essential for working with healthcare providers and team members. These skills ensure accurate audit findings, regulatory compliance, and effective collaboration in the evolving healthcare landscape.

What is a CMS auditor?

A CMS Auditor is responsible for reviewing and assessing compliance with the Centers for Medicare & Medicaid Services (CMS) regulations. They conduct audits of healthcare organizations, insurance providers, or related entities to ensure adherence to policies, billing accuracy, and regulatory standards. Their role involves analyzing documentation, identifying non-compliance issues, and recommending corrective actions. Strong knowledge of healthcare laws, risk assessment, and auditing practices is essential for success in this role.

What are some common challenges faced by CMS auditors, and how can they be managed?

CMS Auditors often navigate the complexities of changing federal and state regulations as well as diverse healthcare billing practices, which can make audits both detailed and challenging. Staying current with regulatory updates, maintaining strong documentation habits, and leveraging audit management tools can help manage these challenges effectively. Regular training and open communication with providers and compliance teams also support accurate, efficient auditing. While the work can be demanding, it offers valuable opportunities to impact healthcare quality and prevent fraud, which many auditors find rewarding.

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What cities are hiring for Cms Auditor jobs? Cities with the most Cms Auditor job openings:
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Cms Auditor jobs near you
Infographic showing various Cms Auditor job openings in the United States as of August 2026, with employment types broken down into 3% As Needed, 82% Full Time, 11% Part Time, and 4% Contract. Highlights an 88% Physical, 3% Hybrid, and 9% Remote job distribution, with an average salary of $76,256 per year, or $36.7 per hour.

Audit Lead (Clinical or Non-Clinical)

Verve LLC

Baltimore, MD • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 10 days ago

Job description

Description:

Job description:

The PACE Audit Lead is responsible for coordinating and leading assigned CMS PACE audit activities from planning through reporting. The Audit Lead serves as the primary point of coordination for the audit team, ensures compliance with CMS audit protocols, and provides technical guidance to auditors throughout the engagement.

The position may be filled by either a clinical (RN) or non-clinical professional with extensive CMS PACE audit experience.

Key Responsibilities

  • Lead assigned CMS PACE audit engagements.
  • Coordinate audit planning, document requests, interviews, and field activities.
  • Ensure compliance with CMS audit protocols and timelines.
  • Review audit documentation for completeness and quality.
  • Provide technical guidance to audit team members.
  • Coordinate with CMS staff, project leadership, and client representatives.
  • Assist in developing audit findings and final reports.
  • Participate in quality assurance reviews.
  • Support corrective action plan evaluations.
  • Perform other related duties as assigned.
Requirements:

Required Qualifications

  • Active RN license (clinical candidates only).
  • Bachelor's degree or equivalent experience.
  • Successful completion of PACE 2026 CMS Auditor Training.
  • Participation in at least two (2) CMS PACE audits during 2026.
  • Minimum five years of healthcare, compliance, auditing, or regulatory experience.
  • Strong leadership, communication, and organizational skills.
  • Ability to obtain and maintain any required government clearance.

Preferred Qualifications

  • Previous CMS contractor experience.
  • Medicare, Medicaid, or PACE regulatory expertise.
  • Project leadership experience.

Why Join Verve?

At Verve, you'll work alongside experienced healthcare professionals supporting mission-critical federal healthcare programs that improve quality, compliance, and patient outcomes. We value integrity, collaboration, continuous learning, and professional growth while providing meaningful opportunities to contribute to the success of our government clients.

Equal Employment Opportunity

Verve, LLC is an Equal Opportunity Employer. We are committed to creating an inclusive workplace and consider all qualified applicants without regard to race, color, religion, sex, national origin, age, disability, veteran status, or any other status protected by applicable federal, state, or local law.

Benefits:

  • 401(k)
  • 401(k) matching
  • Dental insurance
  • Health insurance
  • Health savings account
  • Life insurance
  • Paid time off
  • Vision insurance