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Cms Auditor Jobs (NOW HIRING)

Sharp HealthCare

Compliance Auditor - SRS

San Diego, CA · On-site

$34.17 - $44.09/hr

... CMS and local MAC (Medicare Administrative Contractor) requirements. Required Qualifications * 3 ... Auditing Participates in audit risk assessment for each division/provider to determine trends and ...

Firstsource

Quality Auditor

- Auditor (HB & PB) Role Auditor - Hospital Billing (HB) & Professional Billing (PB) Role Summary ... Ensure compliance with payer guidelines, CMS regulations, and client SOPs * Participate in internal ...

Sharp Healthcare

Compliance Auditor - SRS

San Diego, CA

$34.17 - $44.09/hr

... CMS and local MAC (Medicare Administrative Contractor) requirements. Required Qualifications * 3 ... Auditing Participates in audit risk assessment for each division/provider to determine trends and ...

Firstsource

Quality Auditor

- Auditor (HB & PB)Role Auditor - Hospital Billing (HB) & Professional Billing (PB) Role Summary ... Ensure compliance with payer guidelines, CMS regulations, and client SOPs * Participate in internal ...

Firstsource

Quality Auditor

Louisville, KY

- Auditor (HB & PB) Role Auditor - Hospital Billing (HB) & Professional Billing (PB) Role Summary ... Ensure compliance with payer guidelines, CMS regulations, and client SOPs * Participate in internal ...

MUSC

Compliance Auditor

Charleston, SC · On-site

... CMS-PGBA workplan areas, ad hoc audit requests, and "for cause" coding and billing concerns. The ... Compliance Auditor reports to the Internal Audit Coordinator and performs audits to evaluate ...

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How much do cms auditor jobs pay per year?

As of Jun 8, 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 in the Cms Auditor position, and why are they important?

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 job?

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.

More about Cms Auditor jobs
What cities are hiring for Cms Auditor jobs? Cities with the most Cms Auditor job openings:
What are the most commonly searched types of Cms Auditor jobs? The most popular types of Cms Auditor jobs are:
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Cms Auditor jobs near you
Infographic showing various Cms Auditor job openings in the United States as of May 2026, with employment types broken down into 100% Full Time. Highlights an 86% In-person, and 14% Remote job distribution, with an average salary of $76,256 per year, or $36.7 per hour.
Compliance Auditor - SRS

Compliance Auditor - SRS

Sharp HealthCare

San Diego, CA • On-site

$34.17 - $44.09/hr

Full-time

Posted 22 days ago

Sharp HealthCare rating

8.6

Company rating: 8.6 out of 10

Based on 100 frontline employees who took The Breakroom Quiz

11th of 869 rated healthcare providers

Job description

Hours:
Shift Start Time:
Variable
Shift End Time:
Variable
AWS Hours Requirement:
8/40 - 8 Hour Shift
Additional Shift Information:
Flex hours are 6:00-9:00 am to 14:30-17:30 pm
Weekend Requirements:
As Needed
On-Call Required:
No
Hourly Pay Range (Minimum - Midpoint - Maximum):
$34.170 - $44.090 - $49.370
The stated pay scale reflects the range that Sharp reasonably expects to pay for this position. The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant's years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices.
What You Will Do
To identify and report coding and documentation practices and make recommendations which assure the accurate reporting and documentation of services provided by entity clinical providers. To support and facilitate the implementation of correct coding standards by clinical providers as established by SHC Corporate Compliance in accordance to the CMS and local MAC (Medicare Administrative Contractor) requirements.
Required Qualifications
  • 3 Years experience auditing coding and medical record documentation in an ambulatory care setting.
  • Experience developing training materials and presenting to a large group of professionals.
  • Certified Professional Coder (CPC) - AAPC OR Certified Coding Specialist--Physician-based (CCS-P) - The American Health Information Management Association (AHIMA) -REQUIRED

Other Qualification Requirements
  • Two years of college or five years working experience in a healthcare environment related to auditing of medical records and CMS compliance. - Required

Essential Functions
  • Auditing
    Participates in audit risk assessment for each division/provider to determine trends and helps management identify need for more frequent audits.
    Is able to analyze and create concise reports quantifying and summarizing audit findings. Presents the findings to Departments, Divisions, and at the Individual Provider level.
    Adheres to audit schedules and deadlines; prioritizes workload; communicates to management appropriately regarding workload and priority concerns.
    Utilizes internal and professional resource tools to provide quality audit results.
    Performs concurrent audits according to a defined audit schedule to assure that the documentation meets the standards set by CMS, local Medicare Administrative Contractor (MAC) and other third party payers.
    Performs provider quality audits to ensure provider is billing to meet established coding guidelines.
  • Client support
    Provider, Clinical, and Coding Support
    Serves as a resource providing support to SRS management, physicians, administrative and support staff for coding, documentation and compliance.
    Provides support with TES/CM edit resolution at assigned sites and assists with coding related edit questions.
    Provides professional and courteous support to providers, clinical staff, PFS, via email, phone and in-person contact, answering questions and providing supporting documentation for compliance standards.
  • Communication and training
    Effectively communicates audit results to supervisor, manager and/or director as appropriate.
    Provide timely feedback and final resolution of identified issues.
    Schedules and provides 1:1 training to provider to ensure maximum coding compliance guidelines are followed.
    Evaluates the inpatient and outpatient training and coding areas for improvement for assigned specialties and incorporates education specific to the needs of the specialty.
    Develops and maintains tools, guidelines and procedures to assist in provider's understanding of requirements for medical documentation and coding.
    Performs training for new providers with timely feedback on their documentation.
  • Compliance
    Has a thorough understanding of ICD-10 and CPT coding guidelines.
    Protects all work products, working papers, personal lap top, and other related documents and/or portable electronic data systems in accordance with SHC and regulatory privacy and confidentiality guidelines.
    Stays current with Medicare updates and specialty specific professional services updates; communicates changes to management.
  • Data collection and reporting
    Designs and develops reports within a specified timeframe.
    Analyzes trends while reviewing documentation and communicates to management.
    Reports findings identified during documentation reviews and includes official references related to the findings.
  • Education
    Reviews coding publications for changes, clarifications and/or information pertinent to the medical group's specialties/services.
    Attends and participates in job related conferences, seminars and workshops to enhance skills and keep current on coding and documentation changes.
    Presents to management complete supporting documentation associated with areas of concern.

Knowledge, Skills, and Abilities
  • Excellent working knowledge of CPT, ICD-10 and HCPCS codes is required.
  • Thorough understanding of Medicare, insurance documentation, and compliance and coding requirements.
  • Expert knowledge of MS Office which includes: Excel, Word, and PowerPoint.
  • Ability to educate and train all levels of clinical and professional staff.
  • Excellent interpersonal skills verbal and written, with the ability to communicate to all levels of staff within the organization.
  • Ability to produce high quality work/reports with minimal error rate.
  • Professional approach to work including ability to exercise mature judgement and maintain confidentiality in all activities.

Sharp HealthCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability or any other protected class

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About Sharp HealthCare

Sourced by ZipRecruiter

Sharp HealthCare is a leading healthcare organization based in San Diego, CA, in the US. Founded in 1955, it serves as a critical part of the California healthcare industry, providing a wide range of medical services. The company owns and operates several hospitals, medical groups, and health plans, offering comprehensive healthcare solutions to the residents of San Diego County. The organization's mission is to improve the health of those it serves with a commitment to excellence in all that it does. This commitment is driven by its core values, dubbed "The Sharp Experience," which emphasizes understanding, empathy, and respect towards every individual.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

San Diego, CA, US

Year founded

1955

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