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Remote Cms Auditor Jobs (NOW HIRING)

WPS

Cost Report Auditor

Madison, WI · On-site +1

$47K/yr

Knowledge of CMS Medicare Cost Reporting requirements and Government Auditing Standards. * Experience with audit methodologies, financial analysis, and regulatory compliance. Remote Work Requirements

WPS Health Solutions

Cost Report Auditor

Madison, WI · On-site +1

$47K/yr

Knowledge of CMS Medicare Cost Reporting requirements and Government Auditing Standards. * Experience with audit methodologies, financial analysis, and regulatory compliance. Remote Work Requirements

Evolve Therapy Services

Compliance Auditor (SNF) Remote

OH · Remote

$50K - $60K/yr

The compliance auditor will report directly to the Director of Compliance. This role will be remote ... Knowledge of CMS guidelines for documentation requires and denials process. Benefits: * Competitive ...

New

HealthEdge

Quality Auditor

$35K - $48K/yr

Maintain currency on CMS claims processing rules and guidelines for Medicare Advantage ... Remote, US Type of Employment: Full-time, permanent Work Environment: The physical demands ...

HealthEdge

Quality Auditor

$35K - $48K/yr

Maintain currency on CMS claims processing rules and guidelines for Medicare Advantage ... Remote, US Type of Employment: Full-time, permanent Work Environment: The physical demands ...

Oscar Health

Auditor, Risk Adjustment

Tempe, AZ · Remote

$82K - $108K/yr

This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas ... Conduct CMS audits of Risk Adjustment activities, including but not limited to Risk Adjustment Data ...

Oscar Health

Auditor, Risk Adjustment

Dallas, TX · Remote

$82K - $108K/yr

This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas ... Conduct CMS audits of Risk Adjustment activities, including but not limited to Risk Adjustment Data ...

Oscar Health

Auditor, Risk Adjustment

Miami, FL · Remote

$82K - $108K/yr

This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas ... Conduct CMS audits of Risk Adjustment activities, including but not limited to Risk Adjustment Data ...

Oscar Health

Auditor, Risk Adjustment

Atlanta, GA · Remote

$82K - $108K/yr

This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas ... Conduct CMS audits of Risk Adjustment activities, including but not limited to Risk Adjustment Data ...

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How much do remote cms auditor jobs pay per year?

As of Jun 7, 2026, the average yearly pay for remote cms auditor in the United States is $86,952.00, according to ZipRecruiter salary data. Most workers in this role earn between $84,000.00 and $92,500.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Remote CMS Auditor, and why are they important?

To thrive as a Remote CMS Auditor, you need expertise in healthcare compliance, medical coding, and auditing practices, typically supported by a degree in health information management and relevant certifications such as CPC or RHIA. Familiarity with CMS guidelines, EHR systems, and auditing software is crucial for accurate documentation review. Strong attention to detail, analytical thinking, and effective communication set high performers apart in this role. These competencies ensure compliance with federal regulations, minimize errors, and uphold the integrity of healthcare operations.

What is a Remote CMS Auditor?

A Remote CMS Auditor is a professional who evaluates and reviews an organization's compliance with Centers for Medicare & Medicaid Services (CMS) regulations while working remotely. Their responsibilities include assessing healthcare providers' adherence to CMS policies, conducting audits of medical records and billing practices, and identifying areas of non-compliance. Working remotely, they use secure software and digital tools to analyze data and prepare reports, helping organizations improve their compliance and avoid penalties. This role is vital for maintaining high standards in healthcare service delivery and ensuring proper reimbursement.

What is the difference between Remote Cms Auditor vs Remote Content Reviewer?

AspectRemote Cms AuditorRemote Content Reviewer
Required CredentialsCMS auditing certifications, knowledge of compliance standardsContent moderation training, familiarity with platform policies
Work EnvironmentAnalyzing website content for compliance, often independentlyReviewing user-generated content for appropriateness
Employer & IndustryDigital marketing, media, or publishing companiesSocial media platforms, online marketplaces, content platforms
Search & Comparison IntentUnderstanding compliance and audit processesContent quality and policy enforcement

The Remote Cms Auditor primarily focuses on evaluating website content for compliance with standards and regulations, requiring specific certifications and analytical skills. In contrast, Remote Content Reviewers concentrate on moderating user-generated content to ensure it adheres to platform policies. Both roles are essential in digital content management but differ in scope and expertise required.

How does a Remote CMS Auditor typically collaborate with healthcare providers and internal teams during an audit?

A Remote CMS Auditor frequently works with both healthcare providers and internal compliance teams through virtual meetings, secure document sharing, and regular email communications. The auditor may request documentation, clarify findings, and provide feedback while ensuring all sensitive information is handled in compliance with HIPAA and CMS guidelines. Effective collaboration is essential for accurate assessments and timely resolution of audit issues, so strong communication skills and familiarity with remote tools are key. Additionally, auditors often participate in team meetings to discuss audit results, share best practices, and stay updated on regulatory changes.
More about Remote Cms Auditor jobs
What cities are hiring for Remote Cms Auditor jobs? Cities with the most Remote Cms Auditor job openings:
What are the most commonly searched types of Cms Auditor jobs? The most popular types of Cms Auditor jobs are:
What states have the most Remote Cms Auditor jobs? States with the most job openings for Remote Cms Auditor jobs include:
What job categories do people searching Remote Cms Auditor jobs look for? The top searched job categories for Remote Cms Auditor jobs are:
Remote Cms Auditor jobs near you
Infographic showing various Remote Cms Auditor job openings in the United States as of May 2026, with employment types broken down into 97% Full Time, and 3% Contract. Highlights an 100% Remote job distribution, with an average salary of $86,952 per year, or $41.8 per hour.
Provider Audit and Reimbursement - Sr Auditor (CMS)

Provider Audit and Reimbursement - Sr Auditor (CMS)

ARC Group

Jacksonville, FL • Remote

$75K - $92K/yr

Full-time

Posted 28 days ago

Job description

PROVIDER AUDIT AND REIMBURSEMENT SENIOR AUDITOR (CMS) - REMOTE
ARC Group has an immediate opportunity for a Provider Audit and Reimbursement Senior Auditor (CMS)! This position is 100% remote working eastern time zone business hours. This is a direct hire FTE position and a fantastic opportunity to join a well-respected organization offering tremendous career growth potential.
100% REMOTE!
Candidates must currently have PERMANENT US work authorization.
Job Description:
The Provider Audit and Reimbursement Senior Auditor utilizes advanced knowledge of Medicare laws, regulations, instructions from the Centers for Medicare and Medicaid Services (CMS), and provider policies to perform desk reviews and audits of the annual Medicare cost reports, interim rate review/reimbursement, and settlement acceptance/finalization for all provider types including complex and organ transplant hospitals, as both a preparer and reviewer of work product based on established performance goals. The position will mentor and train Auditors and In-Charge Auditors.
ESSENTIAL DUTIES & RESPONSIBILITIES
Audit Accountabilities (65%)
  • Analyzes the cost report and computes complex rate reviews on large and medium size facilities for accurate intern payments. (10%)
  • Analyzes the cost report and completes the calculation of cost-to-charge ratios (CCRs) and provider payment information, ensuring accuracy. (10%)
  • Analyzes the cost report by comparing the prior year to the current year and completing the desk review, coordinates with Lead on field audits and is in charge of field audits of small, medium and large sized providers and Medicare cost report appeals. (10%)
  • Performs supervisory reviews of desk reviews performed by other members of the audit staff by providing relevant review points that facilitate the coaching, mentoring, and training of less tenured staff. Ensures that provider desk reviews, cost report appeals and field audits are completed in accordance with CMS regulations and Government Auditing Standards. (10%)
  • Establishes or maintains constructive provider relations by demonstrating a professional approach, expressing positive corporate image and assisting provider in problem areas. Advises healthcare providers on Medicare policy questions. (10%)
  • Establishes the timeliness and scheduling of audits and desk reviews to ensure compliance with requirements for CMS metrics and internal production goals. (10%)
  • Accountable for special projects relating to complex payment methodologies. This involves research, project planning, training of staff and timely implementation of CMS requirements. (5%)
Development/Mentoring Accountabilities (30%)
  • Assigns and develops auditors based on their training needs; explains work to be performed and principle or objective of procedure; provides accurate, constructive feedback; determines future training needs. Identifies training needs within the team and department and provides training to staff on reimbursement principles, the process of completing simple to complicated rate reviews, and for reviewing simple to complex rates at the first review level. (10%)
  • Serves as a mentor in the department. (10%)
  • Ensures development of quality product that meets or exceeds CMS expectations. (10%)
Other (5%)
  • Attends entrance and exit conferences and advises healthcare providers on Medicare policy questions as needed. This includes attending and completing the required number of hours of Continuing Education Training (CET). (5%)
REQUIRED QUALIFICATIONS
Bachelors' degree or a combination of education and experience in disciplines such as auditing, accounting, analytics, finance or similar experience in lieu of a degree
In addition to having a thorough understanding of the Medicare cost report, including the step-down method, the candidate must possess the required work experience to independently perform the duties of the position.
To demonstrate the necessary experience, the candidate must have performed the following tasks at a sufficiently successful level to show understanding of the work, judgment, and the ability to perform these tasks independent of supervision, which is generally gained through 2 years of Medicare cost report auditing experience:
  • A Uniform Desk Review (UDR) and an audit for a large or complex hospital, as the in-charge auditor
  • A review of Medicare Bad Debts, inclusive of all relevant sample selection and relevant testing according to CMS standards
  • A review of DSH, inclusive of all relevant sample selection and relevant testing according to CMS standards* A review of IME/GME, inclusive of reviewing rotation schedules, bed count and all relevant testing according to CMS standards
  • A review and appropriate approval of an audit's scope
  • A supervisory review of certain provider types (may vary by team)
  • Sample testing, transferring of testing to the audit adjustment report, and explaining the adjustments to a provider with the achievement of understanding by the provider
Additionally:
  • The auditor must display leadership skills by being integrally involved in junior auditor formal training or assisting on special projects, or have been a Subject Matter Expert (SME)
  • The auditor must be able to prepare workpapers according to CMS standards* The auditor must have a good working knowledge of all applicable software applications
  • The auditor must be able to serve as an effective mentor for less experienced staff
  • The auditor must demonstrate engagement, commitment to departmental success, and professionalism by completing their work within prescribed deadlines, taking ownership of their work and setting an example for more junior auditors and staff by consistently and reliably working the time necessary to properly complete their duties, timely attending meetings, providing adequate notice to management and co-workers when unexpected issues arise, and ensuring work is properly covered in the auditor's absence
  • Demonstrated oral and written communications skills
  • Demonstrated ability to exercise independent judgement and discretionDemonstrated attention to detail
PREFERRED QUALIFICATIONS
  • 2 to 3 years of Medicare cost report auditing experience
  • Demonstrated work experience to independently perform:
    A review of Nursing & Allied Health Education (NAHE), inclusive of calculating the additional add-on payment and all relevant testing
  • A review of Organ Acquisition costs, inclusive of all relevant testing
  • MBA, CPA
This opportunity is open to remote work in the following approved states: AL, AR, FL, GA, ID, IN, IO, KS, KY, LA, MS, NE, NC, ND, OH, PA, SC, TN, TX, UT, WV, WI, WY. Specific counties and cities within these states may require further approval. In FL and PA in-office and hybrid work may also be available.
Would you like to know more about our new opportunity? For immediate consideration, please send your resume directly to John Burke johnb@arcgonline.com or apply online while viewing all of our open positions at www.arcgonline.com.
ARC Group is a Forbes-ranked a top 20 recruiting and executive search firm working with clients nationwide to recruit the highest quality technical resources. We have achieved this by understanding both our candidate's and client's needs and goals and serving both with integrity and a shared desire to succeed.
At ARC Group, we are committed to providing equal employment opportunities and fostering an inclusive work environment. We encourage applications from all qualified individuals regardless of race, ethnicity, religion, gender identity, sexual orientation, age, disability, or any other protected status. If you require accommodations during the recruitment process, please let us know.
Position is offered with no fee to candidate.