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Director Medicare Rac Audit Jobs (NOW HIRING)

The Bell Minor Home

Director MDS - RN

Gainesville, GA · On-site

$34.50 - $41.75/hr

Summary: MDS RAC certified : Manages, directs and coordinates, MDS assessments and completion ... Completes weekly chart audits to assess documentation support for skilled Medicare coverage

The Bell Minor Home

Director MDS - RN

Gainesville, GA · On-site

$34.75 - $42/hr

MDS RAC Certified Nurse Manages, directs and coordinates MDS assessments and completion according ... Completes weekly chart audits to assess documentation support for skilled Medicare coverage.

The Bell Minor Home

Director MDS - RN

Gainesville, GA · On-site

$34.50 - $41.75/hr

Summary: MDS RAC certified : Manages, directs and coordinates, MDS assessments and completion ... Completes weekly chart audits to assess documentation support for skilled Medicare coverage.

Trinity Health

Physician Audit-Educator (757)

Minot, ND · On-site

$193K - $242K/yr

Respond to payor audits conducted by the CMS RAC contractor, Medicare, Medicaid, as well as all ... Self-directed, attention to detail, proficient in Microsoft Office Suite applications including ...

Trinity Health

Physician Audit-Educator (757)

Minot, ND · On-site

$172K - $216K/yr

Respond to payor audits conducted by the CMS RAC contractor, Medicare, Medicaid, as well as all ... Self-directed, attention to detail, proficient in Microsoft Office Suite applications including ...

TRINITY HEALTH

Physician Audit-Educator (757)

Minot, ND · Remote

$193K - $242K/yr

Respond to payor audits conducted by the CMS RAC contractor, Medicare, Medicaid, as well as all ... Self-directed, attention to detail, proficient in Microsoft Office Suite applications including ...

Medvidi

Director, Revenue Cycle Management

San Jose, CA · On-site +1

Role overiew The Director of Revenue Cycle Management will design, build, and operationalize ... Coordinate with General Counsel on payer audit responses, RAC audit preparation, and any compliance ...

Medvidi

Director, Revenue Cycle Management

San Jose, CA · Remote

Role overiew The Director of Revenue Cycle Management will design, build, and operationalize ... Coordinate with General Counsel on payer audit responses, RAC audit preparation, and any compliance ...

Care-One

MDS Specialist RN

Whippany, NJ · On-site

$83K - $120K/yr

Direct the timely and accurate completion of the Minimum Data Set (MDS) and Care Area Assessments ... RAC audits, and pre-payment reviews. IDT Collaboration & Care Meetings: Facilitate ...

Care-One

MDS Specialist RN

Morristown, NJ · On-site

$83K - $120K/yr

Direct the timely and accurate completion of the Minimum Data Set (MDS) and Care Area Assessments ... RAC audits, and pre-payment reviews. IDT Collaboration & Care Meetings: Facilitate ...

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All JobsDirector Medicare Rac Audit Jobs

Director Medicare Rac Audit information

See salary details

$102K

$135.9K

$143.5K

How much do director medicare rac audit jobs pay per year?

As of Jul 3, 2026, the average yearly pay for director medicare rac audit in the United States is $135,863.00, according to ZipRecruiter salary data. Most workers in this role earn between $137,500.00 and $141,000.00 per year, depending on experience, location, and employer.

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.

More about Director Medicare Rac Audit jobs
What cities are hiring for Director Medicare Rac Audit jobs? Cities with the most Director Medicare Rac Audit job openings:
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Director Medicare Rac Audit jobs near you
Infographic showing various Director Medicare Rac Audit job openings in the United States as of June 2026, with employment types broken down into 97% Full Time, 2% Part Time, and 1% Contract. Highlights an 90% Physical, 1% Hybrid, and 9% Remote job distribution, with an average salary of $135,863 per year, or $65.3 per hour.
Medical Review Nurse - CMS/RAC Auditor, Government Audits

Medical Review Nurse - CMS/RAC Auditor, Government Audits

Machinify

Remote

Full-time

Posted 9 days ago

Job description

Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plan clients across the country. Deployed by over 85 health plans, including many of the top 20, and representing more than 270 million lives, Machinify brings together a fully configurable and content-rich, AI-powered platform along with best-in-class expertise. We're constantly reimagining what's possible in our industry, creating disruptively simple, powerfully clear ways to maximize financial outcomes and drive down healthcare costs.
The Medical Review Nurse - CMS / RAC (Government Audits) primarily performs medical claims audit reviews for government clients. As a MR Nurse, you will join a team of experienced medical auditors and coders performing retrospective and prepayment audits on claims for Government Payers. You will work remotely in a fast paced and dynamic environment and be part of a multi-location team.
Please note: RAC certification is preferred for this role. The selected candidate may need to work toward RAC certification if they do not currently have it.
Key Responsibilities:
  • Auditing claims for medically appropriate services provided in both inpatient and outpatient settings while applying appropriate medical review guidelines, policies and rules.
  • Document all findings referencing the appropriate policies and rules.
  • Generate letters articulating audit findings.
  • Supporting your findings during the appeals process if requested.
  • Working collaboratively with the audit team to identify and obtain approval for particular vulnerabilities and/or cases subject to potential abuse.
  • Work in partnership with our clients, CMD colleagues, and other contractors on improving medical policies, provider education, and system edits.
  • Keep abreast of medical practice, changes in technology, and regulatory issues that may affect our clients.
  • Work with the team to minimize the number of appeals; Suggest ideas that may improve audit workflows; Assist with QA functions and training team members.
  • Participate in establishing edit parameters, new issue packets and development of Medical Review Guidelines.
  • Interface with and support the Medical Director and cross train in all clinical departments/areas.
  • Other duties as required to meet business needs.

Knowledge, Skills and Abilities Needed:
  • Experience with utilization management systems or clinical decision-making tools such as Medical Coverage Guidelines (MCG) or InterQual.
  • Experience with and deep knowledge of ICD-9, ICD-10, CPT-4 or HCPCS coding.
  • Knowledge of insurance programs program, particularly the coverage and payment rules.
  • Ability to maintain high quality work while meeting strict deadlines.
  • Excellent written and verbal communication skills.
  • Ability to manage multiple tasks including desk audits and claims review.
  • Must be able to independently use standard office computer technology (e.g. email telephone, copier, etc.) and have experience using a case management system/tools to review and document findings.
  • Must be able to manage multiple assignments effectively, create documentation outlining findings and/or documenting suggestions, organize and prioritize workload
  • Effectively work independently and as a team, in a remote setting.

Required and Preferred Qualifications:
  • Active unrestricted RN license in good standing, is required.
  • Must not be currently sanctioned or excluded from the Medicare program by the OIG.
  • Minimum of five (5) years diversified nursing experience providing direct care in an inpatient or outpatient setting.
  • One (1) or more years' experience performing medical records review.
  • One (1) or more years' experience in health care claims that demonstrates expertise in, ICD-9/ICD-10 coding, HCPS/CPT coding, DRG and medical billing experience for an Insurance Company or hospital required.
  • Strong preference for experience performing utilization review for an insurance company, Tricare, MAC, or organizations performing similar functions.
  • RAC certification preferred.

Equal Employment Opportunity at Machinify
We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender, gender identity or expression, or veteran status. We are proud to be an equal opportunity workplace. Machinify is an employment at will employer. We participate in E-Verify as required by applicable law. In accordance with applicable state laws, we do not inquire about salary history during the recruitment process. If you require a reasonable accommodation to complete any part of the application or recruitment process, please let our recruiters know. See our Candidate Privacy Notice at: https://www.machinify.com/candidate-privacy-notice/

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