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Remote Medicaid Audit Jobs (NOW HIRING)

GDIT

Sr Medicaid Financial Auditor

WV · On-site +1

$140K - $189K/yr

Key Responsibilities Lead and conduct complex financial audits related to Medicaid and CHIP ... Remote Work Location: Any Location / Remote Additional Work Locations: Total Rewards at GDIT: Our ...

Randstad

Medicaid Fraud Investigator

Chicago, IL · Remote

$31.25 - $35/hr

Medicaid Fraud Investigator - Special Investigations Unit (SIU) Location: [Remote - ideally in the ... Perform targeted claim audits (desk and on-site), conduct data analysis, review records, perform ...

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Remote Medicaid Audit information

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$30.5K

$72.6K

$117.5K

How much do remote medicaid audit jobs pay per year?

As of Jul 27, 2026, the average yearly pay for remote medicaid audit in the United States is $72,633.00, according to ZipRecruiter salary data. Most workers in this role earn between $47,000.00 and $98,500.00 per year, depending on experience, location, and employer.

What is the difference between Remote Medicaid Audit vs Remote Medicaid Claims Reviewer?

AspectRemote Medicaid AuditRemote Medicaid Claims Reviewer
CertificationsCPA, CPA, or auditing credentials often preferredMedical billing or coding certifications (e.g., CPC, CCS)
Work EnvironmentAudit firms, healthcare agencies, government officesHealthcare providers, insurance companies, government agencies
Job FocusReviewing financial records, compliance, and audit reportsReviewing claims for accuracy, coding, and eligibility
Common Search IntentAuditing Medicaid programs, compliance, financial reviewClaims processing, billing accuracy, reimbursement issues

Remote Medicaid Audit professionals focus on financial and compliance audits of Medicaid programs, requiring auditing credentials. In contrast, Remote Medicaid Claims Reviewers concentrate on verifying claims for accuracy and proper coding, often with medical billing certifications. Both roles are essential in the Medicaid industry but differ in their primary responsibilities and work environments.

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

To thrive as a Remote Medicaid Auditor, you need a strong background in accounting, healthcare compliance, and Medicaid regulations, often supported by a degree in accounting or healthcare administration. Familiarity with audit software, electronic health records (EHRs), and data analysis tools is typically required, as well as relevant certifications like Certified Internal Auditor (CIA) or Certified Medical Auditor (CMA). Detail orientation, strong analytical thinking, and effective written communication are crucial soft skills for reviewing complex records and reporting findings remotely. These skills ensure accurate, compliant audits that help prevent fraud, reduce errors, and maintain the integrity of Medicaid programs.

What are some of the common challenges faced by professionals in a Remote Medicaid Audit role, and how can they be addressed?

One of the main challenges in a Remote Medicaid Audit position is maintaining effective communication and collaboration with healthcare providers and internal audit teams when working off-site. Additionally, auditors must stay updated on frequently changing Medicaid regulations across different states. To address these challenges, it's important to leverage secure digital tools for document sharing, schedule regular virtual meetings, and participate in ongoing training to stay compliant with current guidelines. Effective time management and attention to detail are also critical for meeting deadlines and ensuring accurate audit results.

What is a Remote Medicaid Audit?

A Remote Medicaid Audit is a review process conducted by auditors who evaluate Medicaid claims and documentation without being physically present at the healthcare facility. These audits are performed virtually, using electronic records and digital communication tools to ensure that providers comply with Medicaid regulations and identify any improper payments or billing errors. Remote audits help maintain program integrity and are often more efficient, reducing the need for on-site visits while still ensuring accuracy and compliance.
More about Remote Medicaid Audit jobs
What cities are hiring for Remote Medicaid Audit jobs? Cities with the most Remote Medicaid Audit job openings:
What are the most commonly searched types of Medicaid Audit jobs? The most popular types of Medicaid Audit jobs are:
What states have the most Remote Medicaid Audit jobs? States with the most job openings for Remote Medicaid Audit jobs include:
What job categories do people searching Remote Medicaid Audit jobs look for? The top searched job categories for Remote Medicaid Audit jobs are:
Remote Medicaid Audit jobs near you
Infographic showing various Remote Medicaid Audit job openings in the United States as of July 2026, with employment types broken down into 92% Full Time, and 8% Part Time. Highlights an 100% Remote job distribution, with an average salary of $72,633 per year, or $34.9 per hour.
Director, Post Pay Audit

Director, Post Pay Audit

Health Business Solutions LLC

Cooper City, FL • Remote

Full-time

Posted 13 days ago

Job description

Job Summary:

We are seeking a highly experienced and strategic Director of Post-Pay Audit to lead our medical revenue recovery audit teams across both onshore (U.S.) and offshore (Philippines) operations. This leader will be responsible for overseeing the execution of comprehensive post-payment audits across commercial and government payers (Medicare, Medicaid, TRICARE, etc.), ensuring compliance, accuracy, and maximum revenue recovery for healthcare provider clients.

The ideal candidate brings deep knowledge of healthcare reimbursement policies, government audit programs (e.g., RAC, UPIC, MAC), and a proven ability to lead cross-functional and cross-cultural teams at scale.

Key Responsibilities:

  • Lead and manage the end-to-end post-pay audit function, including planning, execution, quality assurance, and reporting.
  • Direct and support a global team of audit professionals, ensuring productivity, accuracy, and compliance across both U.S.-based and Philippines-based operations.
  • Oversee audit processes related to government payers and regulatory programs (e.g., CMS RAC, Medicaid Integrity Program, etc.).
  • Establish and refine audit workflows, KPIs, and escalation protocols to optimize audit yield and recovery timelines.
  • Collaborate with compliance, legal, and analytics teams to identify audit opportunities and mitigate risk.
  • Serve as the subject matter expert for payer audit guidelines, CMS regulations, and state-specific requirements.
  • Build strong relationships with internal stakeholders and clients to align audit strategies with broader revenue recovery goals.
  • Develop and execute training programs and professional development plans for onshore and offshore audit staff.
  • Ensure adherence to internal quality standards, HIPAA regulations, and client-specific SLAs.
  • Analyze audit outcomes and present regular performance and risk reports to senior leadership.

Qualifications:

  • Bachelor’s degree in Healthcare Administration, Business, Finance, or related field required; Master’s or MBA preferred
  • Minimum of 7–10 years of experience in post-payment auditing, healthcare reimbursement, or revenue recovery
  • Proven experience managing global teams, including operations based in the Philippines
  • Strong knowledge of government audit programs (RAC, MAC, CERT, ZPIC/UPIC, Medicaid audits)
  • Excellent understanding of healthcare billing, coding (ICD-10, CPT, HCPCS), and payer policies
  • Demonstrated ability to lead process improvement initiatives in large-scale audit operations
  • High proficiency with audit and recovery systems, reporting tools, and workflow platforms
  • Strong communication, leadership, and analytical skills
  • Certification in auditing, billing, or compliance (e.g., CPMA, CPC, CHC) is a plus

Health Business Solutions (HBiz) is an Equal Opportunity Employer. We are committed to providing equal employment opportunities to all employees and applicants without regard to race, color, religion, sex (including pregnancy, sexual orientation, or gender identity), national origin, age, disability, genetic information, veteran status, or any other status protected by applicable federal, state, or local law.

HBiz complies with all applicable employment laws for remote and multi-state hiring and provides reasonable accommodations as required by law.

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