ZipRecruiter

Log In

2

Remote Cms Auditor Jobs (NOW HIRING)

EmblemHealth

Lead Audit Specialist - Remote

New York, NY · On-site +1

$77K - $149K/yr

... to auditors. Coordinate organizational responses to audit findings and facilitate timely ... Manage the coordination of HHS ACA RADV IVA Audits, CMS MA contract level RADV Audits, and ...

Isaac Health

Compliance/Security Officer

New York, NY · On-site +1

$120K - $130K/yr

... CMS. * Auditing, Monitoring, and Reporting * Internal Audits: Define the annual audit calendar ... Strong ability to manage a remote, nationwide workforce. Key Performance Indicators (KPIs) * On ...

Isaac Health

Compliance/Security Officer

New York, NY · Remote

... CMS. * Auditing, Monitoring, and Reporting * Internal Audits: Define the annual audit calendar ... Strong ability to manage a remote, nationwide workforce. Key Performance Indicators (KPIs) * On ...

Curative HR LLC

Senior Auditor, Healthcare Claims

Austin, TX · Remote

$83K - $104K/yr

This is a remote position Key Responsibilities Quality Program Development * Design and implement ... Support internal and external regulatory audits involving CMS, state Departments of Insurance ...

Curative HR LLC

Senior Auditor, Healthcare Claims

Austin, TX · Remote

$83K - $104K/yr

This is a remote position Key Responsibilities Quality Program Development * Design and implement ... Support internal and external regulatory audits involving CMS, state Departments of Insurance ...

AAPC

Senior Auditor-Project Lead

West Valley City, UT · Remote

$82K - $101K/yr

This is a remote position Job Duties: The Sr. Auditor Project Lead will report to the Manager with ... Extensive knowledge of AMA, OIG, CMS and other national coding and compliance guidelines * Serve as ...

New

Orlando Health

Physician Coding Auditor

Orlando, FL · Remote

Remote Location: Orlando, FL Title: Physician Coding Auditor Summary: The Physician Coding Auditor ... CMS, AMA, AHCA and federal registry to support coding practices. • Maintains patient and coder ...

New

Corvel

Clinical Review QC Auditor

Fort Worth, TX · Remote

$68K - $104K/yr

This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Review medical records to ... Proficient understanding of Medicare, CMS guidelines and ICD-10 coding guidelines * Effective and ...

CERiS

Clinical Review QC Auditor

Fort Worth, TX · On-site +1

$68K - $104K/yr

This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Review medical records to ... Proficient understanding of Medicare, CMS guidelines and ICD-10 coding guidelines * Effective and ...

Corvel

Clinical Review QC Auditor

Fort Worth, TX · On-site +1

$68K - $104K/yr

This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Review medical records to ... Proficient understanding of Medicare, CMS guidelines and ICD-10 coding guidelines * Effective and ...

CERiS

Clinical Review QC Auditor

$68K - $104K/yr

This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Review medical records to ... Proficient understanding of Medicare, CMS guidelines and ICD-10 coding guidelines * Effective and ...

CERiS

Clinical Review QC Auditor

Fort Worth, TX · Remote

$68K - $104K/yr

This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Review medical records to ... Proficient understanding of Medicare, CMS guidelines and ICD-10 coding guidelines * Effective and ...

next page

Showing results 1-20

People also search for

All JobsCms Auditor JobsRemote Cms Auditor Jobs

Remote Cms Auditor information

See salary details

$64.5K

$87K

$97.5K

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.
Lead Audit Specialist - Remote

Lead Audit Specialist - Remote

EmblemHealth

New York, NY • On-site, Remote

$77K - $149K/yr

Full-time

Posted 2 days ago

Job description

Summary of Job
Lead and coordinate all phases of external regulatory audits across Medicare Advantage, Medicare Part D, Medicaid Managed Care (including Child Health Plus), and Commercial (on and off exchange) plan products, ensuring timely and accurate data submissions. Plan, manage, and provide oversight for RADV audits, including data analysis to identify required medical records, vendor oversight, project management, and submission of medical records, supporting documents, and data files. Lead and coordinate Part C & D Data Validation audits, including stakeholder communication, data collection and quality review, aggregation, and submission of supporting documentation. Provide operational and regulatory guidance to prepare for audits, minimize audit risk, and protect the organization from adverse financial impacts related to risk adjustment. Manage vendor relationships and contracts to ensure audit vendors follow best practices and support accurate, compliant risk adjustment and enrollment revenue. Collaborate with regulators, internal SMEs, and cross-functional departments to gather, organize, and deliver required documentation to auditors. Coordinate organizational responses to audit findings and facilitate timely remediation or corrective action as needed. Ensure overall audit success by delivering required information accurately and on schedule with minimum disruption to operational areas.
Responsibilities
  • Manage the coordination of HHS ACA RADV IVA Audits, CMS MA contract level RADV Audits, and Commercial on/off exchange products, including HCC validation, Demographic and Enrollment (D&E) validation and Pharmacy Claims ("RXC") validation for all EH and CCI HIOS IDs, etc.
  • Manage external Medicare, Medicaid (including Child Health Plus) and commercial product-related audit efforts, including audits from CMS and its audit contractors/consultants, HHS OIG, NYS DOH, NYS OMIG, NYS Dept of Finance and NYS Office of the State Comptroller.
  • Coordinate the efforts of multiple departments that support our response to these audits.
  • Lead the full audit lifecycle, including announcements, entrance/exit conferences, onsite activities, documentation, delivery of findings, corrective action plan (CAP) collection and tracking, and submission of required monitoring reports to regulatory agencies.
  • Coordinate and organize audit activities across operational areas; serve as the primary liaison to external auditors, including managing onsite visits, documenting meeting minutes, and maintaining the electronic audit archive.
  • Manage end-to-end audit documentation requests, including gathering data, policies, sample materials, and other evidence from internal departments; ensure timely, secure delivery to auditors and maintain a complete archive of deliverables and communications.
  • Ensure regulatory audits for Medicare, Medicaid, and Commercial products are conducted efficiently with minimal business disruption; recommend and implement process improvements to streamline audit and compliance operations.
  • Provide routine audit monitoring reports to CMS and internal leadership as necessary; conduct trend analysis, offer audit planning recommendations, and develop processes to strengthen regulatory compliance and audit readiness.
  • Support and coordinate CMS Part C & Part D IPM, CMS Contract-Level RADV, and HHS OIG RADV audits, including managing medical record retrieval, validating claims/encounter/provider data, and tracking all RADV deliverables.
  • Develop and refine RADV audit strategies, including improvements in medical record retrieval processes and reducing coding errors; manage efforts to enhance RADV audit coordination workflows.
  • Collaborate with internal teams (including, but not limited to Enrollment, Provider Operations, Provider Relations, Network Management, Relationship Managers) to ensure providers, facilities, delegates, and vendors supply required information for the annual IVA audit; implement HHS mandated IVA process changes.
  • Work with the Medicare Compliance and External Audit Leader on process improvement initiatives.
  • Compile data and information to support monitoring reports and reporting to Senior Management as required.
  • Support other Compliance Department activities as directed, assigned, or required.
  • Support organizational initiatives and projects.

Qualifications
  • Bachelor's Degree.
  • 5 - 8+ years' relevant, professional work experience.
  • Experience in healthcare industry - performing/participating in audits (Required)
  • Extensive knowledge of Medicare Advantage and Medicare Prescription Drug Programs; HHS ACA RADV IVA audits; CMS Medicare Advantage contract-level audits; and Commercial on/off-exchange products, including HCC validation, Demographic & Enrollment (D&E) validation, and Pharmacy Claims (RXC) validation across all applicable HIOS IDs (Required)
  • Experience managing external audit activities for Medicare, Medicaid (including Child Health Plus), and commercial product lines, including audits conducted by CMS and its contractors, HHS OIG, NYS DOH, NYS OMIG, NYS Department of Financial Services, and the NYS Office of the State Comptroller; familiarity with regulators' audit processes and requirements (Required)
  • Working knowledge of health insurance operations; understanding of Commercial health insurance, enrollment, and Individual and Small Group coverage, etc. (Required)
  • Additional experience/specialized training may be considered in lieu of educational requirement (Required)
  • Proficiency in the use of Microsoft Office - Word, Excel, Access, PowerPoint, Outlook, Teams, etc. (Required)
  • Ability to organize, prioritize, and successfully manage multiple tasks/projects with simultaneous competing deadlines (Required)
  • Strong analytical and problem-solving skills; and outstanding attention to details (Required)
  • Must be a leader and consensus-builder, able to successfully negotiate with Department heads for the timely delivery of audit data and documents (Required)
  • Must be a team player willing to assist, and correctly advise, operational areas on successful completion of audits, submission of audit deliverables and compliance with regulations (Required)
  • Excellent communication skills (verbal, written, presentation, interpersonal) with all types/levels of audience (Required)
  • Ability to arrange work schedule to meet deadlines from multiple sources and engage staff throughout EmblemHealth to assist in the completion of duties and to travel to all EmblemHealth facilities as needed (Required)
  • Ability to advise Senior Management on regulatory reporting and audit trends and tactics, as well as EmblemHealth's audit vulnerabilities and risks.

Apply