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Remote Cms Auditor Jobs in Silver Spring, MD (NOW HIRING)

RELI GROUP INC

Medical Review Nurse III

Baltimore, MD · Remote

... Recovery Auditor Validation Contract (RVC). Essential Functions * Perform accuracy review of ... Perform accuracy reviews as a Special Study requested by CMS. * Document findings for each claim in ...

RELI Group Inc.

Medical Review Nurse III

Baltimore, MD · Remote

$80K - $95K/yr

... Recovery Auditor Validation Contract (RVC). Essential Functions * Perform accuracy review of ... Perform accuracy reviews as a Special Study requested by CMS. * Document findings for each claim in ...

All JobsCms Auditor JobsRemote Cms Auditor JobsRemote Cms Auditor Jobs in Silver Spring, MD

Remote Cms Auditor information

See Silver Spring, MD salary details

$66.7K

$89.9K

$100.8K

How much do remote cms auditor jobs pay per year?

As of Sep 2, 2026, the average yearly pay for remote cms auditor in Silver Spring, MD is $89,889.00, according to ZipRecruiter salary data. Most workers in this role earn between $86,800.00 and $95,600.00 per year, depending on experience, location, and employer.

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 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.

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 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.

What are the most commonly searched types of Cms Auditor jobs in Silver Spring, MD?

The most popular types of Cms Auditor jobs in Silver Spring, MD are:

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For Remote Cms Auditor jobs in Silver Spring, MD, the most frequently searched job titles are:

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Cities near Silver Spring, MD with the most Remote Cms Auditor job openings:

Remote Cms Auditor jobs near you

CMS PACE Audit Leads - Non-Clinical & Clinical RN Positions

NEXTPHASE HEALTH SOLUTIONS LLC

Baltimore, MD • Remote

Part-time

Posted 27 days ago

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Job description

Join our remote federal oversight team to lead and execute compliance audits for the Programs of All-Inclusive Care for the Elderly (PACE). We are actively recruiting qualified compliance and clinical leaders to fill three specialized leadership roles for the upcoming audit cycle.


Overview & Work Arrangement

Primarily part-time; 100% Remote (must reside and perform all work within one of the 50 United States).


Available Positions & Role-Specific Requirements

1. PACE Audit Lead [Non-Clinical or Clinical (RN)]

  • Directs the full end-to-end audit lifecycle, coordinating planning, staffing, schedules, and conferences across multidisciplinary teams while integrating cross-element findings and overseeing root cause analyses.
  • Licensure: Active Registered Nurse (RN) with unrestricted licensure required if applying as a clinical professional.
  • Requirements: Demonstrated experience planning, coordinating, and leading CMS PACE program audits and review activities; comprehensive knowledge of CMS PACE regulations, guidance, and audit protocols; skilled in developing audit reports, corrective action recommendations, and communicating results directly to CMS and PACE organizations.

2. Service Delivery, Access, and Grievances (SDAG) Lead [Non-Clinical or Clinical (RN)]

  • Directs the compliance evaluation of participant requests, service delivery workflows, appeals, and grievances to ensure adherence to federal timeframes, required notices, and participant protections.
  • Licensure: Active Registered Nurse (RN) with unrestricted licensure required if applying as a clinical professional.
  • Requirements: Demonstrated expertise in CMS PACE SDAG audit protocols; thorough understanding of service delivery requirements, appeals, and grievance processes; experience reviewing case documentation, validating evidence, and evaluating workflows for CMS compliance.

3. Provision of Services Lead [Clinical (RN)]

  • Directs the clinical review element, evaluating whether required services were authorized, coordinated, and delivered in accordance with participant needs and federal program requirements.
  • Licensure: Active Registered Nurse (RN) with unrestricted licensure required.
  • Requirements: Extensive clinical knowledge of PACE interdisciplinary care delivery and participant assessment requirements; hands-on experience evaluating clinical records, care planning, service authorizations, quality of care standards, and clinical evidence to substantiate findings.


Mandatory Qualifications

  • Auditor Training: Successfully completed the CMS PACE 2026 auditor training.
  • Audit Experience: Verified participation in a minimum of two (2) CMS PACE audits during the 2026 audit cycle.
  • Experience: At least 2 years of relevant healthcare compliance, auditing, or clinical oversight experience.
  • Core Skills: Strong analytical, project management, and written communication skills to evaluate data, synthesize evidence, and produce defensible audit documentation.