Director Medicare Rac Audit Jobs (NOW HIRING)

Clinical Audit Response Specialist

Hybrid / Full Time / Portsmouth, NH

At Novocure, we're working to extend the lives of patients battling some of the most aggressive cancers. Every role here contributes to that mission - and as Clinical Audit Response Specialist, you'll help protect reimbursement opportunities by supporting accurate, timely, and compliant responses to payer audits and appeals. You'll work across clinical, reimbursement, and revenue operations teams to turn complex medical-record and payer requirements into clear, well-supported submissions.

ABOUT THE ROLE

We are seeking a detail-oriented Clinical Audit Response Specialist to review and respond to commercial and governmental payer audit activity. You will analyze medical records, prepare appeal documentation and clinical summaries, coordinate audit timelines, and help ensure complete, compliant submissions.

This role also supports accreditation and survey readiness, internal chart review, process improvement, and trend reporting. The ideal candidate is comfortable working independently across multiple deadlines, collaborating with cross-functional partners, and identifying documentation or process risks that may contribute to denials.

WHAT YOU'LL DO

    Review and respond to commercial and governmental payer audits in a timely, accurate, and compliant manner.

    Analyze medical records to support audit responses, appeal arguments, clinical summaries, and documentation packages.

    Coordinate with Reimbursement, Clinical, Revenue Operations, and other internal teams to obtain documentation needed for audit and appeal submissions.

    Prepare, organize, and submit appeal packets, including clinical summaries, payer forms, medical records, prescriptions, proof of delivery, usage information, and other required documentation.

    Support Medicare, Medicaid, commercial payer, prepayment, post-payment, RAC, and other audit or appeal activities as assigned.

    Track audit activity, appeal deadlines, payer responses, outcomes, follow-up dates, and potential revenue impact in designated systems.

    Identify denial trends, documentation gaps, compliance concerns, and operational risks, and communicate findings to management.

    Help develop and improve audit response templates, appeal letters, workflows, policies, and procedures.

    Support accreditation activities, survey readiness, evidence preparation, and responses to audit- or survey-related documentation requests.

    Maintain confidential patient and company information in accordance with Novocure policies, HIPAA requirements, and applicable regulatory standards.

    Build effective working relationships with internal stakeholders, external payers, auditors, and other business partners.

    Participate in payer discussions, teleconference hearings, training, knowledge sharing, team projects, and process improvement initiatives as needed.

ABOUT YOU

You are a thoughtful, analytical professional who can review complex clinical and payer information and turn it into clear, accurate documentation. You are organized, attentive to detail, and comfortable balancing multiple deadlines while maintaining confidentiality and compliance.

You communicate effectively with clinical and business partners, work well both independently and collaboratively, and can identify trends, summarize findings, and raise risks or opportunities to management.

Qualifications

    Ability to review and interpret medical records, payer requests, denial rationale, coverage criteria, and supporting documentation.

    Strong written and verbal communication skills, including the ability to prepare clear, accurate, and persuasive appeal documentation.

    Strong analytical thinking, problem solving, prioritization, and attention to detail.

    Ability to manage multiple deadlines and assignments while maintaining accuracy and compliance.

    Ability to work independently and collaboratively in a fast-paced environment.

    Ability to identify trends, summarize findings, and communicate risks or opportunities to management.

    Familiarity with Microsoft Office products.

    Ability to maintain confidentiality and comply with company policies, security requirements, and regulatory expectations.

    Commitment to Novocure's patient-forward mission and values.

Preferred Qualifications:

    Bachelor's degree and 3-5 years of experience in clinical, audit, reimbursement, or revenue cycle work.

    Clinical background, nursing degree, medical-record review experience, or comparable healthcare experience.

    Experience with payer audits, claims appeals, DME, medical device, oncology, revenue cycle, reimbursement, or clinical documentation.

    Knowledge of Medicare, Medicaid, commercial payer audit processes, appeal requirements, and timely filing expectations.

    Experience with SAP, CRM, payer portals, work queues, audit trackers, or similar systems.

HOW YOU'LL WORK

    This is a full-time, exempt position reporting to the Manager, Audit Response and based in Portsmouth, NH.

    Hybrid or remote work expectations may vary based on business needs.

    Attendance may be required for onsite audits, accreditation surveys, hearings, or other business-critical activities.

    Ability to lift up to 20 pounds.

WHAT WE OFFER

The pay range which Novocure expects to pay for this role at the time of this posting is $84,000- $112,000/yr. This position may also be eligible for an annual bonus and restricted stock unit grant in addition to a full range of benefits. Individual compensation within this range depends on a variety of factors, including, but not limited to, prior education and experience, job-related knowledge and skills demonstrated.

ABOUT NOVOCURE:

Novocure is a company with a powerful mission, to extend the lives of people living with some of the most aggressive forms of cancer. Here your work will have a direct impact on patients and those who care about them. Join a team of passionate, collaborative people who support each other, challenge one another, and innovate together. Here, you'll connect, grow, and make a real difference. We're a company with the drive of a startup and the strength that comes with 25 years of success.

Novocure operates at a rare crossroad, where advanced medical technology converges with cutting-edge biotechnology. We are the only company to develop and commercialize Tumor Treating Fields (TTFields), a proprietary, groundbreaking therapy designed to disrupt cancer cell division. With us you will find a unique combination of laboratory research work alongside engineering development of advanced technologies. This fusion of disciplines positions us as true pioneers in oncology innovation, leading a new frontier in the treatment of aggressive cancers.

Our patient-forward values

- innovation

- focus

- drive

- courage

- trust

- empathy

Novocure is an Equal Opportunity Employer.  All qualified applicants will receive consideration for employment without regard to race, color, religion, sexual orientation, gender identity, age, national origin, disability, protected veteran status or other characteristics protected by federal, state, or local law. We actively seek qualified candidates who are protected veteran and individuals with disabilities as defined under VEVRAA and Section 503 of the Rehabilitation Act.

Novocure is committed to providing an interview process that is inclusive of our applicant's needs. If you are an individual with a disability and would like to request an accommodation, please email NovocureRecruitingEEO@novocure.com

If you're excited about this role, we encourage you to apply.