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Director Medicare Rac Audit Jobs in Florida (NOW HIRING)

Hospital Coding Auditor

Pensacola, FL · On-site

$25.75 - $29.25/hr

This position may audit accounts for ER Charging accuracy and perform RAC and other third party ... Experience in regulatory issues related to Medicare, and other third party payers as it relates to ...

Hospital Coding Auditor

Pensacola, FL · On-site

$24 - $27.25/hr

This position may audit accounts for ER Charging accuracy and perform RAC and other third party ... Experience in regulatory issues related to Medicare, and other third party payers as it relates to ...

Hospital Coding Auditor

Pensacola, FL · On-site

$25.75 - $29.25/hr

This position may audit accounts for ER Charging accuracy and perform RAC and other third party ... Experience in regulatory issues related to Medicare, and other third party payers as it relates to ...

Hospital Coding Auditor

Pensacola, FL · On-site

$24 - $27.25/hr

This position may audit accounts for ER Charging accuracy and perform RAC and other third party ... Experience in regulatory issues related to Medicare, and other third party payers as it relates to ...

This position may audit accounts for ER Charging accuracy and perform RAC and other third party ... Experience in regulatory issues related to Medicare, and other third party payers as it relates to ...

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Director Medicare Rac Audit information

What is the difference between Director Medicare Rac Audit vs Medicare RAC Auditor?

AspectDirector Medicare RAC AuditMedicare RAC Auditor
CertificationsCMS certifications, auditing credentialsCMS certifications, auditing credentials
Work EnvironmentManagement, strategy, oversightField audits, data analysis
Employer & Industry UsageHealthcare organizations, government agenciesMedicare contractors, healthcare providers

The main difference is that the Director Medicare RAC Audit oversees and manages RAC audit programs, focusing on strategy and compliance, while the Medicare RAC Auditor conducts the actual audits and reviews claims. The director has a leadership role, whereas the auditor performs detailed, hands-on audit work.

What are the most commonly searched types of Medicare Rac Audit jobs in Florida?

The most popular types of Medicare Rac Audit jobs in Florida are:

What cities in Florida are hiring for Director Medicare Rac Audit jobs?

Cities in Florida with the most Director Medicare Rac Audit job openings:

Director, Post Pay Audit

Health Business Solutions LLC

Cooper City, FL • Remote

Full-time

Re-posted 26 days ago


Key responsibilities

  • Lead and manage the end-to-end post-pay audit function, including planning, execution, quality assurance, and reporting.

  • Direct and support a global team of audit professionals, ensuring productivity, accuracy, and compliance across U.S. and offshore operations.

  • Oversee audit processes related to government payers and regulatory programs, and analyze audit outcomes to report performance and risks to senior leadership.


Job description

Job Summary:

We are seeking a highly experienced and strategic Director of Post-Pay Audit to lead our medical revenue recovery audit teams across both onshore (U.S.) and offshore (Philippines) operations. This leader will be responsible for overseeing the execution of comprehensive post-payment audits across commercial and government payers (Medicare, Medicaid, TRICARE, etc.), ensuring compliance, accuracy, and maximum revenue recovery for healthcare provider clients.

The ideal candidate brings deep knowledge of healthcare reimbursement policies, government audit programs (e.g., RAC, UPIC, MAC), and a proven ability to lead cross-functional and cross-cultural teams at scale.

Key Responsibilities:

  • Lead and manage the end-to-end post-pay audit function, including planning, execution, quality assurance, and reporting.
  • Direct and support a global team of audit professionals, ensuring productivity, accuracy, and compliance across both U.S.-based and Philippines-based operations.
  • Oversee audit processes related to government payers and regulatory programs (e.g., CMS RAC, Medicaid Integrity Program, etc.).
  • Establish and refine audit workflows, KPIs, and escalation protocols to optimize audit yield and recovery timelines.
  • Collaborate with compliance, legal, and analytics teams to identify audit opportunities and mitigate risk.
  • Serve as the subject matter expert for payer audit guidelines, CMS regulations, and state-specific requirements.
  • Build strong relationships with internal stakeholders and clients to align audit strategies with broader revenue recovery goals.
  • Develop and execute training programs and professional development plans for onshore and offshore audit staff.
  • Ensure adherence to internal quality standards, HIPAA regulations, and client-specific SLAs.
  • Analyze audit outcomes and present regular performance and risk reports to senior leadership.

Qualifications:

  • Bachelor’s degree in Healthcare Administration, Business, Finance, or related field required; Master’s or MBA preferred
  • Minimum of 7–10 years of experience in post-payment auditing, healthcare reimbursement, or revenue recovery
  • Proven experience managing global teams, including operations based in the Philippines
  • Strong knowledge of government audit programs (RAC, MAC, CERT, ZPIC/UPIC, Medicaid audits)
  • Excellent understanding of healthcare billing, coding (ICD-10, CPT, HCPCS), and payer policies
  • Demonstrated ability to lead process improvement initiatives in large-scale audit operations
  • High proficiency with audit and recovery systems, reporting tools, and workflow platforms
  • Strong communication, leadership, and analytical skills
  • Certification in auditing, billing, or compliance (e.g., CPMA, CPC, CHC) is a plus

Health Business Solutions (HBiz) is an Equal Opportunity Employer. We are committed to providing equal employment opportunities to all employees and applicants without regard to race, color, religion, sex (including pregnancy, sexual orientation, or gender identity), national origin, age, disability, genetic information, veteran status, or any other status protected by applicable federal, state, or local law.

HBiz complies with all applicable employment laws for remote and multi-state hiring and provides reasonable accommodations as required by law.