Medical Reviewer Auditor

Job Title: Full-Time Medical Review Auditor

Location: New Jersey (Remote/Onsite as required)
Employment Type: Full-Time

Position Overview:
Genesis Consulting Support is seeking experienced Medical Review Auditors to support Medicaid provider audits in compliance with New Jersey state regulations. Auditors will be responsible for conducting utilization reviews, interpreting state Medicaid policies, and ensuring audit accuracy, consistency, and timeliness. This position requires a keen understanding of Medicaid/Medicare guidelines and a high level of clinical and regulatory expertise.

We are hiring approximately 20 full-time Medical Review Auditors at a ratio of 1 auditor per 2,500 reviews annually to meet project demands.

Minimum Qualifications:

• Must hold an active New Jersey Registered Nurse (RN) license in good standing.

• At least three (3) years of experience as a nurse conducting Medicaid or Medicare utilization review (UR) audits.

• Demonstrated working knowledge of Medicaid provider audits, including audit tools, data analysis, and provider engagement.

• Strong ability to interpret and apply New Jersey State Medicaid regulations and policies effectively.

• Excellent analytical, written, and communication skills.

Preferred Attributes:

• Experience with claims systems or Medicaid Management Information Systems (MMIS)

• Familiarity with CMS guidelines and audit protocols

• Ability to work independently and within a multidisciplinary team

Placement Type:
Full-time | Contract | Remote options may be available depending on contract terms