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60 Cms Auditor Jobs Hiring Near You

We are seeking a Risk Adjustment Coding Auditor with 8+ years of experience to support first- and second-pass audits for CMS RADV (Risk Adjustment Data Validation) projects. The ideal candidate must ...

Risk Adjustment Coding Auditor

Albany, NY · On-site

$27 - $30.75/hr

We are seeking a Risk Adjustment Coding Auditor with 8+ years of experience to support first- and second-pass audits for CMS RADV (Risk Adjustment Data Validation) projects. The ideal candidate must ...

HIM Coding Auditor

Wayne, PA · On-site

$24.75 - $28/hr

... per CMS Local Coverage Determination (LCD). Applies working knowledge of medical terminology ... Auditing experience required. * AAPC CPC Certification required. * Healthcare (professional ...

Provider Auditor II

Fargo, ND · On-site +1

$52K - $78K/yr

Mentors Auditor I and Auditor II level staff by training, coaching, and providing constructive and ... CMS Access Compliance and Regulation Contingency Statement Some positions require compliance with ...

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Audit Lead (Clinical or Non-Clinical)

Verve LLC

Baltimore, MD • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 11 days ago


Job description

Description:

Job description:

The PACE Audit Lead is responsible for coordinating and leading assigned CMS PACE audit activities from planning through reporting. The Audit Lead serves as the primary point of coordination for the audit team, ensures compliance with CMS audit protocols, and provides technical guidance to auditors throughout the engagement.

The position may be filled by either a clinical (RN) or non-clinical professional with extensive CMS PACE audit experience.

Key Responsibilities

  • Lead assigned CMS PACE audit engagements.
  • Coordinate audit planning, document requests, interviews, and field activities.
  • Ensure compliance with CMS audit protocols and timelines.
  • Review audit documentation for completeness and quality.
  • Provide technical guidance to audit team members.
  • Coordinate with CMS staff, project leadership, and client representatives.
  • Assist in developing audit findings and final reports.
  • Participate in quality assurance reviews.
  • Support corrective action plan evaluations.
  • Perform other related duties as assigned.
Requirements:

Required Qualifications

  • Active RN license (clinical candidates only).
  • Bachelor's degree or equivalent experience.
  • Successful completion of PACE 2026 CMS Auditor Training.
  • Participation in at least two (2) CMS PACE audits during 2026.
  • Minimum five years of healthcare, compliance, auditing, or regulatory experience.
  • Strong leadership, communication, and organizational skills.
  • Ability to obtain and maintain any required government clearance.

Preferred Qualifications

  • Previous CMS contractor experience.
  • Medicare, Medicaid, or PACE regulatory expertise.
  • Project leadership experience.

Why Join Verve?

At Verve, you'll work alongside experienced healthcare professionals supporting mission-critical federal healthcare programs that improve quality, compliance, and patient outcomes. We value integrity, collaboration, continuous learning, and professional growth while providing meaningful opportunities to contribute to the success of our government clients.

Equal Employment Opportunity

Verve, LLC is an Equal Opportunity Employer. We are committed to creating an inclusive workplace and consider all qualified applicants without regard to race, color, religion, sex, national origin, age, disability, veteran status, or any other status protected by applicable federal, state, or local law.

Benefits:

  • 401(k)
  • 401(k) matching
  • Dental insurance
  • Health insurance
  • Health savings account
  • Life insurance
  • Paid time off
  • Vision insurance