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Medicaid Auditor Jobs (NOW HIRING)

Contact Government Services, LLC

Auditor

Knoxville, TN · On-site

$80K - $100K/yr

Auditor Employment Type: Full-Time, Experienced Department: Financial CGS is seeking a highly ... Review, analyze, and interpret complex data, including Centers for Medicare & Medicaid claims data ...

BCForward

Auditor (medical/healthcare)

Austin, TX · Remote

$27 - $28.88/hr

The MAG Auditor audits financial and statistical cost reporting data to accurately determine provider's reimbursement rates for processing of Medicaid claims Process Description: The MAG Auditor ...

Imagine Pediatrics

Coding Compliance Auditor

$75K - $90K/yr

Interpret and apply state-specific Medicaid and payer billing requirements, maintain expertise ... Prior coding or auditing experience in a Medicaid environment. * Experience providing individual ...

Myers and Stauffer

Senior Auditor

Baltimore, MD · Hybrid

$80K - $98K/yr

... state Medicaid agencies, and the federal Center for Medicare & Medicaid Services). We have 45 ... auditing, public accounting, or related field * Experience with Medicare and Medicaid cost ...

TEKsystems

Risk Adjustment Coding Auditor

Phoenix, AZ · Remote

$32 - $37/hr

Knowledge of Medicare, Medicaid, and ACA Commercial risk adjustment models. * Ability to interpret ... Risk Adjustment Auditing * HCC Coding * ICD-10-CM Coding * Risk Adjustment Programs * Medicare ...

CBIZ

Senior Auditor

Baltimore, MD · Hybrid

$80K - $98K/yr

... state Medicaid agencies, and the federal Center for Medicare & Medicaid Services). We have 45 ... auditing, public accounting, or related field * Experience with Medicare and Medicaid cost ...

StateJobsNY

Information Systems Auditor 2 - 283

Albany, NY · On-site

$106K - $131K/yr

The Information Systems Auditor 2 is a key position in support of the oversight and planning for ... Additional Comments The NYSOH System is key component of New York's Medicaid Enterprise system ...

Covenant Health

COMPLIANCE AUDITOR

Knoxville, TN · Remote

Compliance Auditor Full Time, 80 Per Hour Pay Period, Day Shift This position is Remote. Covenant ... with Medicare, Medicaid guidelines and other insurance payor guidelines. * Coordinates with ...

Covenant Health

COMPLIANCE AUDITOR

Knoxville, TN · On-site +1

Overview Compliance Auditor Full Time, 80 Per Hour Pay Period, Day Shift This position is Remote ... with Medicare, Medicaid guidelines and other insurance payor guidelines. * Coordinates with ...

Norton Healthcare

Manager, Reimbursement

Louisville, KY · On-site

Hospital presidents and vice-presidents, associate CFO, CFO, Business Office personnel) as well as external stakeholders (i.e. consultants, financial auditors, bond holders, and Medicare and Medicaid ...

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All JobsMedicaid Auditor Jobs

Medicaid Auditor information

See salary details

$10

$19

$46

How much do medicaid auditor jobs pay per hour?

As of Aug 10, 2026, the average hourly pay for medicaid auditor in the United States is $19.21, according to ZipRecruiter salary data. Most workers in this role earn between $14.42 and $19.23 per hour, depending on experience, location, and employer.

What is the difference between Medicaid Auditor vs Medicaid Claims Processor?

AspectMedicaid AuditorMedicaid Claims Processor
CredentialsRelevant certifications (e.g., CPA, auditing credentials), knowledge of Medicaid regulationsBasic healthcare or administrative certifications, familiarity with claims processing systems
Work EnvironmentOffice-based, auditing Medicaid records and complianceOffice or healthcare facility, processing Medicaid claims and data entry
Employer & IndustryGovernment agencies, healthcare organizations, insurance companiesHealthcare providers, insurance companies, Medicaid agencies
Search & Comparison IntentUnderstanding auditing roles, compliance, and regulationsProcessing claims, billing, and reimbursement procedures

Medicaid Auditors focus on reviewing and ensuring Medicaid compliance through audits, requiring specialized knowledge and certifications. Medicaid Claims Processors handle the entry and processing of claims, focusing on billing and reimbursement. Both roles are essential in Medicaid operations but differ in responsibilities and expertise.

What is a Medicaid auditor?

Medicaid Auditors are professionals who review and evaluate healthcare providers' records and billing practices to ensure compliance with Medicaid regulations. Their primary role is to detect and prevent fraud, waste, and abuse within the Medicaid program by conducting audits, analyzing claims, and verifying that services billed to Medicaid were actually provided and are properly documented. Medicaid Auditors may work for state or federal agencies, as well as private firms contracted by government entities. Their work helps ensure that Medicaid funds are used appropriately and that healthcare providers adhere to all relevant laws and policies.

What are the key skills and qualifications needed to thrive as a Medicaid auditor, and why are they important?

To thrive as a Medicaid Auditor, you need a solid understanding of accounting principles, healthcare regulations, and Medicaid policies, typically supported by a degree in accounting, finance, or a related field. Familiarity with audit software, healthcare billing systems, and data analysis tools such as Excel or ACL is often required, along with relevant certifications like CPA or CFE being advantageous. Strong attention to detail, analytical thinking, and effective communication are critical soft skills that set top auditors apart. These competencies ensure accurate assessments, compliance with regulations, and the ability to detect and prevent fraud or financial discrepancies within Medicaid programs.

What are some common challenges faced by Medicaid auditors, and how can they be addressed?

Medicaid Auditors often encounter challenges such as navigating complex and frequently changing federal and state regulations, managing large volumes of data, and dealing with incomplete or inconsistent documentation from healthcare providers. To address these challenges, auditors must stay current with regulatory updates, develop strong analytical skills, and maintain clear communication with providers to obtain necessary records. Collaborating closely with compliance teams and participating in ongoing training can also help auditors effectively manage these complexities and ensure accurate, thorough audits.
More about Medicaid Auditor jobs
What cities are hiring for Medicaid Auditor jobs? Cities with the most Medicaid Auditor job openings:
What states have the most Medicaid Auditor jobs? States with the most job openings for Medicaid Auditor jobs include:
What job categories do people searching Medicaid Auditor jobs look for? The top searched job categories for Medicaid Auditor jobs are:
Medicaid Auditor jobs near you
Infographic showing various Medicaid Auditor job openings in the United States as of August 2026, with employment types broken down into 2% As Needed, 81% Full Time, 13% Part Time, and 4% Contract. Highlights an 87% Physical, 2% Hybrid, and 11% Remote job distribution, with an average salary of $39,947 per year, or $19.2 per hour.

Auditor

Contact Government Services, LLC

Knoxville, TN • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 25 days ago

Job description

Auditor
Employment Type: Full-Time, Experienced
Department: Financial
CGS is seeking a highly skilled Senior Auditor to provide general auditing and accounting services in support of fraud investigations involving potentially complex financial transactions and complex organizations attempting to evade detection. The ideal candidate will develop, coordinate, and draft technical audit guidelines, is proficient in a variety of accounting systems, and practices excellent cross-functional communication throughout investigations.
CGS brings motivated, highly skilled, and creative people together to solve the government's most dynamic problems with cutting-edge technology. To carry out our mission, we are seeking candidates who are excited to contribute to government innovation, appreciate collaboration, and can anticipate the needs of others. Here at CGS, we offer an environment in which our employees feel supported, and we encourage professional growth through various learning opportunities.
Job Description:
- The Auditor will work under the direction of the client attorneys within the specific client unit. The Auditor will perform audit activities related to the detection and investigation of fraud, waste or abuse in Government programs, including health care fraud, defense procurement fraud, contractor fraud, Paycheck Protection Program (PPP) loan fraud, and other government program fraud.
Typical work assignments may include, but not limited to the following, while complying with established procedures.
• Conduct audits in support of investigations and litigation involving the government's affirmative civil enforcement of federal laws, particularly the False Claims Act, 31 U.S.C. §§3729-3733, the Anti-Kickback Statute, 42 U.S.C. § 1320a-7b(b)(1)(A), and the Stark Law, 42 U.S.C. § 1395nn(a).
• Review, analyze, and interpret complex data, including Centers for Medicare & Medicaid claims data, PPP loan data, and activities of entities and individuals
involved in health care fraud, defense procurement contract fraud, and other government program fraud
• Identify possible outlier billings within specific codes, which are the payment driver for health care claims
• Normalize claims data across several health benefit plans in order to perform a time study or other assessment of the claims, such as identifying the day of the week a provider visits a skilled nursing facility
• Identify trends or other data within records obtained through investigation or discovery and use that information to test the data for various conditions
• Re-interpret (extrapolate) results of a Statistically Valid Random Sample if changes are made to the sample review results
• Develop and defend loss calculation methodologies
• Conduct financial investigations and analyses to assess the ability of individuals and organizations to pay settlements and judgments
• Actively communicate with witnesses, persons of interest, and local/state/federal agency representatives to gather facts, identify sequence of events, and obtain statements and relevant information
• Examine documents including financial records, reports, correspondence, and computer data to identify fact patterns and analyze relationships between new and existing facts/parties/evidence
• Provide recommendations and assist attorneys with development of investigative plans and including identifying areas of investigative focus based on data reviewed
Requirements:
- Education / Certification Requirement: Must be Certified Public Accountant. MBA or equivalent in accounting or directly related field. Thorough knowledge of generally accepted accounting principles and generally accepted auditing standards.
- Minimum of three years' experience as an auditor
- Minimum two years specialized experience in the specific subject matter area involved - for example, Medicare billing and claims systems, or DoD inventory systems
- Working knowledge of appropriate accounting and financial analysis ADP systems and applications
- Excellent oral and written communication skills
- Experience in litigation environment, experience working with automated litigation support helpful.
- Must be a US citizen & able to obtain a Public Trust security clearance
Our Commitment:
Contact Government Services (CGS) strives to simplify and enhance government bureaucracy through the optimization of human, technical, and financial resources. We combine cutting-edge technology with world-class personnel to deliver customized solutions that fit our client's specific needs. We are committed to solving the most challenging and dynamic problems.
For the past seven years, we've been growing our government-contracting portfolio, and along the way, we've created valuable partnerships by demonstrating a commitment to honesty, professionalism, and quality work.
Here at CGS we value honesty through hard work and self-awareness, professionalism in all we do, and to deliver the best quality to our consumers mending those relations for years to come.
We care about our employees. Therefore, we offer a comprehensive benefits package.
- Health, Dental, and Vision
- Life Insurance
- 401k
- Flexible Spending Account (Health, Dependent Care, and Commuter)
- Paid Time Off and Observance of State/Federal Holidays
Contact Government Services, LLC is an Equal Opportunity Employer. Applicants will be considered without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
Join our team and become part of government innovation!
Explore additional job opportunities with CGS on our Job Board:
https://cgsfederal.com/join-our-team/
For more information about CGS please visit: https://www.cgsfederal.com or contact:
Email: [email protected]
$80,000 - $100,000 a year
We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses and identifying potential inconsistencies or verification signals in application materials based on available information. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.

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