Medicare Compliance Auditor - Salary, Education and Career Guide for Becoming a Medicare Compliance Auditor

In 2008, the Centers for Medicare and Medicaid Services (CMS) announced that they would take increased steps to identify improper Medicare payments. Since the announcement, Medicare compliance auditors have been established in 19 states. Other states will be added every six months. All states are expected to be part of the program by 2010.

Job Description

The main job of a Medicare auditor is to identify improper payments that may have been caused by duplicate billing, incorrect coding or non-covered services. However, if they discover possible fraud, they will refer the cases for investigation.
 
Compliance auditors plan, direct and control provider audits. They also conduct entire audits independently. On team audits, they may assign, review and approve work done by auditors and audit specialists. Compliance auditors also tackle reimbursement issues with providers and consultants.
 
A compliance auditor must have good written and verbal communication skills. Other important skills include:
  • ability to work independently and exercise good judgment
  • analytical skills
  • computer skills
  • planning and organizational skills.
 

Salary Guide

Medicare compliance auditor salary varies widely depending on location, experience and employer. The position is normally lucrative. The median salary for compliance auditors is $69,764 per year. Compliance auditors on the higher end of the pay scale can command annual salaries of $90,000 or more.

Education and Training

If you are thinking of becoming a Medicare compliance auditor, you will typically need a Bachelor's in Accounting. Some employers prefer candidates with CPA (certified public accountant) designations. Other companies are more lenient and will consider candidates with degrees in the following areas:
  • business administration
  • finance
  • public administration.
 
However, these employers usually also require a certain number of semester hours in accounting. In addition, Medicare auditors in some states must complete a requisite number of continuing education credits each year.

Prior Work Experience

To be eligible for a position as a compliance auditor, you should ideally have at least three to five years of related experience under your belt. Experience can consist of any of the following:
  • making audit determinations on cost-representation accuracy, fairness of cost proposals or reliability of accounting systems

  • testing and examining a subject's cost representations

  • using audit techniques, such as sampling

  • working as an auditor in charge of planning, performing and reporting audit assignments.
 

Career Advancement

Entry-level compliance auditors may be promoted to auditor-in-charge after two to four years of full-time work. Exemplary auditors can move up to senior management and executive positions. These jobs command a higher salary and more responsibility. However, competition for senior-level jobs is intense and may require several years of experience in the field.
 
Related Associations and Groups
  • American Association of Medical Audit Specialists
  • American Institute of Certified Public Accountants
  • Association of Healthcare Internal Auditors
  • Institute of Internal Auditors
  • New England Healthcare Internal Auditors.
 
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