Senior Provider Auditor

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Senior Provider Auditor based in the United States.

Take on a key role in ensuring accurate Medicare reimbursement and regulatory compliance through comprehensive provider audits and financial reviews. As a Senior Provider Auditor, you will evaluate healthcare provider cost reports, assess compliance with federal requirements, and help identify opportunities to strengthen audit quality and reduce financial risk. You will bring advanced knowledge of Medicare regulations, accounting principles, and reimbursement methodologies to complex audit assignments. Beyond your technical expertise, you will mentor colleagues, support staff development, and contribute to consistent auditing practices across the team. You will also build professional relationships with healthcare providers, offering guidance and communicating audit findings with clarity and professionalism. This fully remote opportunity combines independent analytical work, collaborative problem-solving, and meaningful contributions to the integrity of healthcare reimbursement.

Accountabilities

Conduct Medicare-related financial analyses, desk reviews, and in-house or on-site field audits to verify the accuracy of healthcare provider reimbursement and compliance with applicable requirements.
Apply advanced knowledge of Medicare rules and regulations, including the Code of Federal Regulations and Provider Reimbursement Manual, to evaluate Medicare Cost Reports and reimbursement calculations.
Review audit documentation, testing procedures, and workpapers to ensure accuracy, completeness, and adherence to established methodologies and policies.
Assess compliance with applicable procedures, identify deficiencies or potential risks, recommend corrective action plans, and prepare comprehensive reports communicating audit findings.
Provide technical guidance, professional judgment, and strategic recommendations to junior and intermediate auditors to strengthen quality control and minimize organizational risk.
Mentor team members through coaching, training, constructive feedback, and knowledge sharing to improve their technical capabilities and overall performance.
Support the onboarding and development of new and existing employees by delivering training on audit techniques, desk review methodologies, departmental policies, and procedures.
Perform supervisory-level reviews of less complex assignments and provide actionable feedback to improve audit consistency, efficiency, and quality.
Establish and maintain strong, professional relationships with healthcare providers and facility management throughout the audit process.
Participate in internal training initiatives and external provider education and outreach activities to promote understanding of Medicare reimbursement requirements.
Maintain professional knowledge and continuing education requirements, including a minimum of 80 continuing education training hours every two years.
Follow all applicable privacy, security, compliance, and segregation-of-duties requirements, including HIPAA and relevant federal regulations.
Perform additional related duties as assigned.
Requirements
A bachelor's degree in Accounting, Business, Finance, or a related discipline, or equivalent professional experience.
At least three years of experience in Medicare auditing, with demonstrated familiarity with provider reimbursement reviews and healthcare financial analysis.
Advanced knowledge of Medicare rules and regulations, including the Code of Federal Regulations, Provider Reimbursement Manual, and requirements governing Medicare Cost Reports.
Strong understanding of accounting principles, financial analysis, audit documentation, testing methodologies, and reimbursement practices.
Proficiency in Microsoft Office applications, particularly Word, Excel, Outlook, and PowerPoint.
Excellent written and verbal communication skills, with the ability to explain complex audit findings, regulatory requirements, and corrective actions clearly.
Strong analytical, organizational, and problem-solving abilities, with exceptional attention to detail and the capacity to manage audit assignments effectively.
Demonstrated ability to coach, advise, mentor, and develop colleagues while maintaining high standards of accuracy and professional judgment.
Strong interpersonal and relationship-management skills, including the ability to communicate professionally with healthcare providers, facility representatives, and internal stakeholders.
Ability to prepare reports, deliver presentations, provide constructive feedback, and support training initiatives.
A demonstrated understanding of broader industry requirements and organizational objectives, with the ability to apply sound judgment when assessing risks and recommending improvements.
Ability to work independently in a remote environment while collaborating effectively with colleagues and adhering to established procedures.
Willingness to maintain continuing education requirements and stay current with changes in Medicare reimbursement regulations and audit practices.
Candidates must be located within one of the 50 U.S. states or the District of Columbia. Depending on applicable federal contract requirements, eligibility for federal identity credentials, background clearance, and authorized system access may also be required.
Benefits
Annual salary range: $59,937.84–$98,582.59, depending on geographic location, relevant experience, job-related knowledge, skills, and internal equity.
Eligibility for an incentive plan and lifestyle benefits.
Remote work arrangement, offering flexibility to work from home within the United States.
Health, dental, and vision insurance.
Voluntary insurance plans.
Health Savings Account (HSA) and Flexible Spending Account (FSA) options.
401(k) retirement plan with employer matching contributions.
Company-paid life insurance.
Education assistance and professional development opportunities.
Paid sick leave and paid holidays.
Paid time off through an increasing accrual plan.
Medical, parental, and disability leave.
Workers' compensation coverage and retiree benefits.
Employee assistance program and financial and health wellness resources.
Severance package, subject to applicable eligibility terms.
Casual dress environment and access to an online learning system.