Senior Medicare Auditor (CMS)
Location: Jacksonville, FL
Job Type: Direct Placement
Company: ARC Group
Category: Administration
Job Description Apply Now
Senior Medicare Auditor (CMS) – Remote, Full-TimeARC Group is seeking a dedicated and experienced Senior Medicare Auditor (CMS) to join our team in a full-time, remote capacity. This role is a key opportunity for individuals with a deep understanding of Medicare reimbursement, cost report auditing, and Centers for Medicare & Medicaid Services (CMS) compliance. The position is designed for professionals who are passionate about healthcare audit practices and enjoy mentoring others while maintaining the highest standards of accuracy and regulatory adherence.
Responsibilities- Conduct in-depth desk reviews and audits of annual Medicare cost reports for all provider types, including complex and organ transplant hospitals.
- Perform both preparer and reviewer functions, ensuring all work products meet established performance and CMS regulatory goals.
- Analyze cost reports and execute complex rate reviews for large and medium-sized healthcare facilities to ensure accurate interim payments and cost-to-charge ratios.
- Compare current and prior year cost reports, coordinate with team leads on field audits, and take charge of field audits for providers of varying size and complexity.
- Supervise and review audit work by less experienced staff, providing constructive feedback to facilitate learning and maintain compliance with government audit standards.
- Advise healthcare providers on intricate Medicare policy questions and foster strong provider relationships through professional and constructive communication.
- Manage audit timeliness and scheduling to meet internal production goals and CMS-imposed deadlines.
- Lead or participate in special projects related to complex payment methodologies, including research, project planning, staff training, and timely implementation of CMS requirements.
- Attend entrance and exit conferences with providers, ensuring all communications and documentation are compliant with professional standards.
- Assign, develop, and mentor auditors based on training needs, providing clear explanations of audit procedures and actionable feedback.
- Contribute to departmental training by preparing team members to complete simple to highly complex rate reviews and audits.
- Serve as a mentor within the department, ensuring the development and delivery of high-quality audit products that meet or exceed CMS expectations.
- Bachelor’s degree in auditing, accounting, finance, analytics, or a related field, or equivalent experience in lieu of a degree.
- At least 2 years of Medicare cost report auditing experience, with demonstrated ability to independently conduct Uniform Desk Reviews (UDR), hospital audits, and Medicare Bad Debt reviews.
- Experience with DSH, IME/GME, and the review and approval of audit scopes per CMS standards.
- Strong leadership skills, with involvement in junior auditor training, special projects, or subject matter expertise.
- Ability to prepare audit workpapers to CMS standards and proficiency with relevant software applications.
- Excellent oral and written communication skills, attention to detail, and the ability to exercise independent judgment and discretion.
- Demonstrated commitment to professionalism, meeting deadlines, and setting a positive example for team members.
- 2-3 years of direct Medicare cost report auditing experience.
- Experience with Nursing & Allied Health Education (NAHE) and Organ Acquisition cost reviews.
- Advanced degrees or certifications such as MBA or CPA.
This Senior Medicare Auditor (CMS) position is a remote, full-time opportunity that supports a positive work-life balance while allowing you to contribute meaningfully to the healthcare sector. Remote work is available in approved states, providing flexibility and accessibility for qualified candidates. Working remotely in the Eastern time zone offers the advantage of collaborating with a diverse, multi-state team while enjoying the comfort and convenience of your own home office.
ARC Group is a Forbes-ranked top 20 recruiting and executive search firm committed to integrity, success, and fostering inclusive opportunities. We provide equal employment opportunities and encourage applications from all qualified individuals regardless of race, ethnicity, religion, gender identity, sexual orientation, age, disability, or any other protected status. If you require accommodations during the recruitment process, please notify us.
Position is offered with no fee to candidate.