The Government Recovery Specialist performs duties associated with Centers for Medicare and Medicaid Services (CMS) Recovery Audit Contractor (RAC) program and other government regulatory and ...
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The Government Recovery Specialist performs duties associated with Centers for Medicare and Medicaid Services (CMS) Recovery Audit Contractor (RAC) program and other government regulatory and ...
Quick apply
The Government Recovery Specialist performs duties associated with Centers for Medicare and Medicaid Services (CMS) Recovery Audit Contractor (RAC) program and other government regulatory and ...
Ontario, CA · On-site
$71K - $94K/yr
Is responsible for maintaining integrity of tracking Government review audits (RAC, MAC, CERT, OIG ... Provides supervision and direction for Medicare and Medicaid Appeals process along with analysis ...
Ontario, CA · On-site
$71K - $94K/yr
Is responsible for maintaining integrity of tracking Government review audits (RAC, MAC, CERT, OIG ... Provides supervision and direction for Medicare and Medicaid Appeals process along with analysis ...
$71K - $94K/yr
Is responsible for maintaining integrity of tracking Government review audits (RAC, MAC, CERT, OIG ... Provides supervision and direction for Medicare and Medicaid Appeals process along with analysis ...
$71K - $94K/yr
Is responsible for maintaining integrity of tracking Government review audits (RAC, MAC, CERT, OIG ... Provides supervision and direction for Medicare and Medicaid Appeals process along with analysis ...
Ontario, CA · On-site
$71K - $94K/yr
Is responsible for maintaining integrity of tracking Government review audits (RAC, MAC, CERT, OIG ... Provides supervision and direction for Medicare and Medicaid Appeals process along with analysis ...
Ontario, CA · On-site
$71K - $94K/yr
Is responsible for maintaining integrity of tracking Government review audits (RAC, MAC, CERT, OIG ... Provides supervision and direction for Medicare and Medicaid Appeals process along with analysis ...
... resources." Medicare defines Medical necessity as "health care services or supplies needed to ... Leads in RAC preparedness and assists facility in the time of RAC Audits. * Participates in ...
... resources." Medicare defines Medical necessity as "health care services or supplies needed to ... Leads in RAC preparedness and assists facility in the time of RAC Audits. * Participates in ...
$53.10 - $58.39/hr
... resources." Medicare defines Medical necessity as "health care services or supplies needed to ... Leads in RAC preparedness and assists facility in the time of RAC Audits. * Participates in ...
$53.10 - $58.39/hr
... resources." Medicare defines Medical necessity as "health care services or supplies needed to ... Leads in RAC preparedness and assists facility in the time of RAC Audits. * Participates in ...
San Gabriel, CA · On-site
$53.10/hr
... resources." Medicare defines Medical necessity as "health care services or supplies needed to ... Leads in RAC preparedness and assists facility in the time of RAC Audits. * Participates in ...
San Gabriel, CA · On-site
$53.10/hr
... resources." Medicare defines Medical necessity as "health care services or supplies needed to ... Leads in RAC preparedness and assists facility in the time of RAC Audits. * Participates in ...
Castro Valley, CA · On-site
... education, RAC audit resources, and back office support at one of our more than 700 clinics ... Adhere to all safety regulations; compliance with Medicare, HIPAA and other governmental ...
Castro Valley, CA · On-site
... education, RAC audit resources, and back office support at one of our more than 700 clinics ... Adhere to all safety regulations; compliance with Medicare, HIPAA and other governmental ...
Castro Valley, CA · On-site
... education, RAC audit resources, and back office support at one of our more than 700 clinics ... Adhere to all safety regulations; compliance with Medicare, HIPAA and other governmental ...
Castro Valley, CA · On-site
... education, RAC audit resources, and back office support at one of our more than 700 clinics ... Adhere to all safety regulations; compliance with Medicare, HIPAA and other governmental ...
Riverside, CA · On-site
$105K - $145K/yr
... audits (RAC, MAC, OIG, UPIC, commercial payers), and strong knowledge of CMS IPPS/OPPS regulations, OIG Work Plan priorities, Medicare Conditions of Participation, Official Coding Guidelines, NCCI ...
Riverside, CA · On-site
$105K - $145K/yr
... audits (RAC, MAC, OIG, UPIC, commercial payers), and strong knowledge of CMS IPPS/OPPS regulations, OIG Work Plan priorities, Medicare Conditions of Participation, Official Coding Guidelines, NCCI ...
Riverside, CA · On-site
$105K - $145K/yr
... audits (RAC, MAC, OIG, UPIC, commercial payers), and strong knowledge of CMS IPPS/OPPS regulations, OIG Work Plan priorities, Medicare Conditions of Participation, Official Coding Guidelines, NCCI ...
Riverside, CA · On-site
$105K - $145K/yr
... audits (RAC, MAC, OIG, UPIC, commercial payers), and strong knowledge of CMS IPPS/OPPS regulations, OIG Work Plan priorities, Medicare Conditions of Participation, Official Coding Guidelines, NCCI ...
Ontario, CA · On-site
Receives, Tracks, review, submit, and overall gatekeeper of all Medicare audit notifications ie Probe, RAC, CERTS, etc * Communicates and provide Corporate team with materials required for yearly ...
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Ontario, CA · On-site
Receives, Tracks, review, submit, and overall gatekeeper of all Medicare audit notifications ie Probe, RAC, CERTS, etc * Communicates and provide Corporate team with materials required for yearly ...
Ontario, CA · On-site
$130K - $140K/yr
Receives, Tracks, review, submit, and overall gatekeeper of all Medicare audit notifications ie Probe, RAC, CERTS, etc * Communicates and provide Corporate team with materials required for yearly ...
Ontario, CA · On-site
$130K - $140K/yr
Receives, Tracks, review, submit, and overall gatekeeper of all Medicare audit notifications ie Probe, RAC, CERTS, etc * Communicates and provide Corporate team with materials required for yearly ...
Walnut Creek, CA · On-site
$28 - $33/hr
Support internal and external audit readiness (RAC, MAC, payer audits). * Reporting & KPI ... Experience with Medicare and commercial payer guidelines * Ability to work in a fast ...
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Walnut Creek, CA · On-site
$28 - $33/hr
Support internal and external audit readiness (RAC, MAC, payer audits). * Reporting & KPI ... Experience with Medicare and commercial payer guidelines * Ability to work in a fast ...
$33 - $38/hr
... audits, including RAC, Medicare Advantage, Medicaid, and commercial payer reviews * Provide education and mentoring to coding staff and other stakeholders * Monitor changes in coding guidelines ...
$33 - $38/hr
... audits, including RAC, Medicare Advantage, Medicaid, and commercial payer reviews * Provide education and mentoring to coding staff and other stakeholders * Monitor changes in coding guidelines ...
$63K - $83K/yr
Experience navigating RAC, MAC, UPIC, and OIG audit processes. Familiarity with value-based care ... Comprehensive knowledge of Medicare and Medicaid billing regulations, including UB-04 and CMS-1500 ...
$63K - $83K/yr
Experience navigating RAC, MAC, UPIC, and OIG audit processes. Familiarity with value-based care ... Comprehensive knowledge of Medicare and Medicaid billing regulations, including UB-04 and CMS-1500 ...
$63K - $83K/yr
Experience navigating RAC, MAC, UPIC, and OIG audit processes. Familiarity with value-based care ... Comprehensive knowledge of Medicare and Medicaid billing regulations, including UB-04 and CMS-1500 ...
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$63K - $83K/yr
Experience navigating RAC, MAC, UPIC, and OIG audit processes. Familiarity with value-based care ... Comprehensive knowledge of Medicare and Medicaid billing regulations, including UB-04 and CMS-1500 ...
$21.75 - $33.04/hr
Responds to audit requests (including RAC) from payors and maintains a Library of Payer reference ... Medicare/Medi-Cal reimbursement methodologiesPreferred: Patient accounting experience in a high ...
$21.75 - $33.04/hr
Responds to audit requests (including RAC) from payors and maintains a Library of Payer reference ... Medicare/Medi-Cal reimbursement methodologiesPreferred: Patient accounting experience in a high ...
Fremont, CA · On-site
$58K - $77K/yr
Experience navigating RAC, MAC, UPIC, and OIG audit processes. Familiarity with value-based care ... Comprehensive knowledge of Medicare and Medicaid billing regulations, including UB-04 and CMS-1500 ...
Fremont, CA · On-site
$58K - $77K/yr
Experience navigating RAC, MAC, UPIC, and OIG audit processes. Familiarity with value-based care ... Comprehensive knowledge of Medicare and Medicaid billing regulations, including UB-04 and CMS-1500 ...
... RAC) staff * Encourages continuous awareness and education of unit staff, which may include ... audit observations in order to enhance HIPAA and FWA case management performance * Leads or ...
... RAC) staff * Encourages continuous awareness and education of unit staff, which may include ... audit observations in order to enhance HIPAA and FWA case management performance * Leads or ...
To excel in a Medicare RAC Audit role, you need a thorough understanding of Medicare regulations, auditing practices, and healthcare compliance, often supported by credentials such as a Certified Professional Medical Auditor (CPMA) or similar. Familiarity with audit management software, electronic health records (EHRs), and data analysis tools is commonly required. Attention to detail, analytical thinking, and clear written and verbal communication are important soft skills for producing accurate audit findings and interacting with providers. These skills ensure the identification of improper payments, maintenance of compliance, and support for healthcare organizations in navigating complex Medicare requirements.
A Medicare RAC (Recovery Audit Contractor) Audit job involves reviewing Medicare claims to identify and recover improper payments made to healthcare providers. RAC auditors analyze medical records, billing data, and coding practices to ensure compliance with Medicare guidelines. They work to detect overpayments and underpayments, helping to prevent fraud, waste, and abuse in the Medicare system. This role requires knowledge of medical coding, billing regulations, and healthcare compliance.
Professionals in Medicare RAC Audit roles are primarily responsible for reviewing medical records and claims to identify and report improper payments or billing errors under Medicare guidelines. On a daily basis, you may analyze complex data, prepare detailed audit reports, communicate findings with healthcare providers, and collaborate with other compliance or billing team members to ensure corrections are implemented. The work often involves balancing independent research with collaborative meetings to resolve issues and maintain compliance. This position offers a fast-paced environment that requires strong organizational skills and provides significant exposure to Medicare policies and healthcare operations.

$25 - $35/hr
Full-time
Medical, Dental, Vision, Life, Retirement, PTO
Posted 11 days ago
Adecco Healthcare is working with our client in Costa Mesa, CA to hire an on-site Government Audit Recovery Specialist for a temporary assignment.
Type: Temp/Contract
Hours: Monday - Friday 8a-5p
Pay Range: $25-$35/hour - DOE
Responsibilities Include:
The Government Recovery Specialist performs duties associated with Centers for Medicare and Medicaid Services (CMS) Recovery Audit Contractor (RAC) program and other government regulatory and enforcement agency audits for documentation and billing compliance including:
- data entry
- processing of mail
- preparation of audit information
- correspondence with government contractors as needed
- responsible for responding to correspondence from Government Agencies related to Recovery Audit Contractor (RAC), Medicare Administrative Contractor (MAC), Targeted Provider Education (TPE), Comprehensive Error Rate Testing (CERT), Office of Inspector General (OIG), Quality Improvement Organizations (QIO) and other Medicaid, Medi-Cal regulatory auditing body for pre and post payment audits
Requirements Include:
- HS Diploma or GED
-A fundamental understanding of the RAC program and other audits for documentation and billing compliance
• 3 years of Medicare billing experience in billing, follow up, in an acute care setting
• Experience working on complex projects
• 1-3 years of experience in healthcare acute setting regulatory audits and appeals
• Experience with and understanding of CMS billing, payment and reimbursement methodologies
• Knowledge of privacy regulations, security regulations, release of information, CMS rules and regulations
• Proficiency in Microsoft Office applications (Word, PowerPoint, Excel, Outlook)
Preferred Requirements Include:
• 5 years of experience or more in an acute setting
• 3 years of experience in healthcare acute setting regulatory audits and appeals
• Experience working on government, Recovery Audit Contractor (RAC), Medicare Administrative Contractor (MAC), Targeted Provider Education (TPE), Comprehensive Error Rate Testing (CERT), Office of Inspector General (OIG), and other Medicaid, Medi-Cal and other regulatory audits
• 5 years of experience in Medicare billing, follow up, appeals
• Knowledge of utilization management process, coding, medical necessity criteria
Why work for Adecco?
· Weekly Pay
· 401(k) Plan
· Skills Training
· Excellent medical, dental, and vision benefits
Massachusetts Candidates Only: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.
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