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Remote Cms Auditor Jobs in Virginia (NOW HIRING)

This position is remote but does require onsite education to providers as needed. Essential Duties ... auditing) to ensure documentation and selection of HCC diagnosis codes meet the requirements set ...

Remote Cms Auditor information

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

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.
What are the most commonly searched types of Cms Auditor jobs in Virginia? The most popular types of Cms Auditor jobs in Virginia are:
What cities in Virginia are hiring for Remote Cms Auditor jobs? Cities in Virginia with the most Remote Cms Auditor job openings:
Infographic showing various Remote Cms Auditor job openings in Virginia as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution.

Senior Revenue Cycle Management Project Manager (Systems, Reporting, SLA experience)

Microhealth LLC

Vienna, VA • On-site, Remote

$95K - $100K/yr

Full-time

Re-posted 14 days ago


Job description

MicroHealth is seeking an experienced and strategic Senior Revenue Cycle Management Project Manager to lead enterprise-level financial initiatives within healthcare organizations. This senior-level position requires a dynamic leader with extensive hands-on management experience (10+ years minimum) who can drive cross-functional teams to streamline patient access, billing, and collections processes while optimizing technology platforms and ensuring regulatory compliance to maximize cash flow and minimize claim denials.
Position Overview
The Senior Revenue Cycle Management Project Manager oversees complex, multi-faceted revenue cycle programs from end to end. This role demands a strategic thinker who can balance operational excellence with financial performance, leveraging data analytics and process improvement methodologies to achieve measurable results. The ideal candidate will serve as a key liaison between clinical, financial, and IT departments to align revenue goals with broader organizational objectives.
Location: Remote
Work Hours: Eastern Standard Time (EST)
Position Type: Full-time
Key Responsibilities
  • Apply formal project management methodologies (Agile, Waterfall, Hybrid) to manage scope, timelines, budgets, and risks across complex front-, middle-, and back-end revenue cycle programs
  • Lead cross-functional teams including clinical staff, billing specialists, IT professionals, and executive stakeholders
  • Develop comprehensive project charters, work breakdown structures, and communication plans
  • Monitor project milestones and deliverables, ensuring alignment with organizational strategic goals
  • Manage and report on Service Level Agreements (SLAs), ensuring compliance with contractual obligations and performance metrics
  • Identify operational bottlenecks and inefficiencies across the revenue cycle continuum
  • Design and implement standardized workflows to increase efficiency and reduce errors
  • Deploy automation solutions to streamline repetitive tasks and improve accuracy
  • Conduct process mapping and gap analysis to identify improvement opportunities
  • Champion change management initiatives to ensure successful adoption of new processes
  • Analyze claim rejection and denial trends to identify root causes and systemic issues
  • Direct targeted strategies to improve clean claim rates and accelerate reimbursement cycles
  • Collaborate with coding and billing teams to address documentation deficiencies
  • Implement denial prevention programs and appeal processes
  • Monitor payer-specific requirements and adjust workflows accordingly
  • Track and report on core Key Performance Indicators (KPIs) including:
    • Days in Accounts Receivable (A/R)
    • Net collection rates
    • Clean claim rates
    • Denial rates and appeal success rates
    • Point-of-service collections
    • Cost-to-collect ratios
  • Generate routine executive reports and dashboards for senior leadership
  • Develop comprehensive reporting frameworks to support data-driven decision-making
  • Conduct variance analysis and recommend corrective actions
  • Present findings and recommendations to C-suite executives and board members
  • Act as a strategic liaison between clinical, financial, and IT departments
  • Facilitate regular meetings with stakeholders to ensure alignment on revenue goals
  • Translate complex financial and technical concepts for diverse audiences
  • Build consensus among competing priorities and resource constraints
  • Maintain transparent communication channels with all project participants
  • Ensure all billing and coding practices adhere to federal, state, and payer regulations
  • Stay current on regulatory changes including CMS guidelines, HIPAA requirements, and payer policies
  • Oversee internal and external auditing processes to ensure compliance and accuracy
  • Coordinate with compliance officers to address audit findings and implement corrective action plans
  • Develop and maintain compliance documentation and standard operating procedures
  • Apply certification knowledge in coding, billing, and auditing to ensure best practices
  • Demonstrate proficiency with Careview and InnovAlone platforms
  • Optimize Electronic Health Record (EHR) system configurations to support revenue cycle workflows
  • Collaborate with IT teams on system implementations, upgrades, and integrations
  • Exhibit strong system savvy to quickly learn and adapt to new technologies and platforms
  • Evaluate and recommend revenue cycle management software and tools
  • Ensure data integrity across multiple systems and platforms

Required Qualifications
  • Bachelor's degree in healthcare administration, Business, Finance, Health Information Management, or a related field required
  • Minimum 10+ years of extensive hands-on management experience in healthcare revenue cycle management with demonstrated success leading large-scale projects or transformations
  • Proven track record of managing enterprise-level revenue cycle initiatives from conception through implementation
  • Experience with Careview and InnovAlone systems required
  • Demonstrated expertise in reporting and managing Service Level Agreements (SLAs)
  • Experience working in remote/distributed team environments
  • Background in healthcare operations, finance, or health information management
  • Certified Revenue Cycle Professional (CRCP), Certified Revenue Cycle Representative (CRCR), or similar revenue cycle certification required
  • Certification in coding (CPC, CCS, or equivalent), billing, and/or auditing required
Technical Skills
  • Advanced proficiency with Careview and InnovAlone platforms (required)
  • Exceptional system experience with ability to quickly master new technologies and software applications
  • Proficiency in major Electronic Health Record (EHR) systems such as Epic, Cerner, Meditech, or Allscripts
  • Advanced skills in data analytics tools including Tableau, Power BI, Microsoft Excel, or SQL
  • Experience with revenue cycle management software and billing systems
  • Strong understanding of medical coding (ICD-10, CPT, HCPCS) and billing regulations
  • Familiarity with claims processing systems and clearing houses
  • Expertise in developing and managing reporting frameworks and dashboards
  • Demonstrated ability to manage and monitor Service Level Agreements (SLAs)
  • Change management expertise with proven ability to drive adoption of new processes and technologies
  • Attention to detail and accuracy particularly in financial and compliance matters
Salary: $110,000-$120,000
Physical Demands:
While performing the duties of this job, the employee is regularly required to sit. The employee frequently is required to walk; use hands to finger, handle or feel; reach with hands and arms; and talk or hear. The employee is occasionally required to stand. The employee may lift or move objects up to 5 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, and the ability to adjust focus.
MicroHealth will recruit, hire, train, and promote persons in all job titles, and ensure that all other personnel actions are administered without regard to race, color, religion, sex, sexual orientation, gender identity, genetic information, national origin, disability, or status as a protected veteran and ensure that all employment decisions are based only on valid job requirements.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
If you need reasonable accommodation due to a disability for any part of the employment process, please send an e-mail to [email protected] with your request and contact information.