Senior Provider Auditor

Overview

This position is eligible for Remote / Work from Home, with the requirement that physical work location must be in one of the 50 states or the District of Columbia (as a condition of employment).

Job Summary

The Senior Provider Auditor conducts Centers for Medicare & Medicaid Services (CMS) and other financial analysis, limited and full desk reviews, and in-house and on-site field audits to help ensure proper reimbursement for health care providers for Medicare programs. This role serves as a primary point of contact for providers and facilities management through the audit process, requiring an advanced level of professionalism.

Auditors review assigned portions of audit programs, determine compliance with applicable policies and procedures, recommend corrective action plans, and prepare and submit reports on audit results.

Responsibilities

• Maintain a high level of working knowledge of Medicare rules and regulations (e.g., Code of Federal regulations, Provider Reimbursement Manual) to ensure reimbursement principles are properly applied to the Medicare Cost Report so Medicare reimbursement is accurate.
• Mentor staff at all levels through training, coaching, and constructive, positive feedback.
• Assist with training for new and existing employees on department techniques, desk review and audit methodologies, policies, and procedures.
• Provide professional judgment, strategic insight, and guidance to Provider Auditor I and II’s using knowledge, experience, and research to ensure quality control is adequate and minimize risk for the team.
• Perform less complex supervisory-level reviews and coach staff with feedback to strengthen knowledge and skills.
• Maintain strong, professional working relationships with providers.
• Apply extensive knowledge of documentation requirements from audit testing through preparation of audit workpapers.
• Provide training to internal staff and participate in external outreach and education to the provider community.
• Obtain a minimum of 80 CET hours every two years.

Minimum Qualifications

• Bachelor’s degree in Accounting, Business, Finance, or equivalent work experience.
• 3 years’ Medicare auditing experience.
• Knowledge of accounting theory and practices.
• Proficiency in Microsoft Office Suite (Word, Excel, Outlook, and PowerPoint).
• Advanced knowledge of Medicare rules and regulations (e.g., Code of Federal Regulations, Provider Reimbursement Manual) to ensure reimbursement principles are properly applied to the Medicare Cost Report so Medicare reimbursement is accurate.

Preferred Qualifications

• Bachelor’s degree in Accounting, Business, or Finance.
• Excellent written and verbal communication skills.
• Excellent organizational skills.
• Ability to coach, advise, and develop others.
• Demonstrated understanding of industry and enterprise objectives.
• Excellent presentation skills.

Compensation & Benefits

• Health, Dental, and Vision Insurance
• Voluntary Insurance Plans
• Health Savings and Flexible Spending Accounts
• 401k and Company Match
• Company-paid Life Insurance
• Education Assistance Program
• Paid Sick Leave
• Paid Holidays
• Increasing PTO Accrual Plan
• Medical/Parental/Disability Leave
• Workers Compensation
• Retiree Benefits
• Employee Assistance Program
• Financial and Health Wellness Benefits
• Casual Dress
• Open Office Setting
• Online Learning System

Salary Range

• $59,937.84 – $90,695.98 per year
• Base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors.

Other Compensation

• Incentive Plan & Lifestyle Benefit

CMS Access Compliance and Regulation Contingency Statement

Some positions require compliance with (i) federal and agency-specific regulations and related clauses included in government prime contracts, (ii) background checks, and (iii) eligibility for a government-issued identification card.

An employee in this position may be required to possess a “Federal Identification Card” (Federal ID) as a condition of employment. Federal ID’s may include one of the following: Personal Identity Verification (PIV) card, Personal Identity Verification-Interoperable (PIV-I) card, a Local-Based Physical Access Card issued by CMS, or a Local-Based Physical Access Card issued by another Federal agency and approved by CMS.

Obtaining a Federal ID and continued eligibility for this position may require successful completion of a Federal Background Investigation performed by the Federal Government and a residency requirement that you have lived in the United States at least three out of the last five years. Failure to obtain a Federal ID may result in removal from the position or termination of employment.

Equal Employment Opportunity

Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status, or other characteristics protected by state or federal law.

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is:

• (a) in response to a formal complaint or charge,
• (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or
• (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)

Application Closing Date

This job will be closed 09/11/2026 at 8:00AM CST. No further applications will be considered.