MDS Specialist RN
$83K - $120K/yr
... RAC audits, and pre-payment reviews. * IDT Collaboration & Care Meetings: Facilitate ... Thorough knowledge of CMS RAI guidelines, Medicare PPS/OBRA scheduling, and federal/state long-term ...
MDS Specialist RN
$83K - $120K/yr
... RAC audits, and pre-payment reviews. * IDT Collaboration & Care Meetings: Facilitate ... Thorough knowledge of CMS RAI guidelines, Medicare PPS/OBRA scheduling, and federal/state long-term ...
MDS Specialist RN
Morristown, NJ · On-site
$83K - $120K/yr
... RAC audits, and pre-payment reviews. * IDT Collaboration & Care Meetings: Facilitate ... Thorough knowledge of CMS RAI guidelines, Medicare PPS/OBRA scheduling, and federal/state long-term ...
MDS Specialist RN
Morristown, NJ · On-site
$83K - $120K/yr
... RAC audits, and pre-payment reviews. * IDT Collaboration & Care Meetings: Facilitate ... Thorough knowledge of CMS RAI guidelines, Medicare PPS/OBRA scheduling, and federal/state long-term ...
MDS Specialist RN
$83K - $120K/yr
... RAC audits, and pre-payment reviews. * IDT Collaboration & Care Meetings: Facilitate ... Thorough knowledge of CMS RAI guidelines, Medicare PPS/OBRA scheduling, and federal/state long-term ...
MDS Specialist RN
$83K - $120K/yr
... RAC audits, and pre-payment reviews. * IDT Collaboration & Care Meetings: Facilitate ... Thorough knowledge of CMS RAI guidelines, Medicare PPS/OBRA scheduling, and federal/state long-term ...
MDS Specialist RN
Whippany, NJ · On-site
$83K - $120K/yr
... RAC audits, and pre-payment reviews. * IDT Collaboration & Care Meetings: Facilitate ... Thorough knowledge of CMS RAI guidelines, Medicare PPS/OBRA scheduling, and federal/state long-term ...
MDS Specialist RN
Whippany, NJ · On-site
$83K - $120K/yr
... RAC audits, and pre-payment reviews. * IDT Collaboration & Care Meetings: Facilitate ... Thorough knowledge of CMS RAI guidelines, Medicare PPS/OBRA scheduling, and federal/state long-term ...
MDS Specialist RN
Morristown, NJ · On-site
$83K - $120K/yr
... Rac audits, and pre-payment reviews. * Idt Collaboration & Care Meetings: Facilitate ... Thorough knowledge of Cms Rai guidelines, Medicare Pps/Obra scheduling, and federal/state long-term ...
MDS Specialist RN
Morristown, NJ · On-site
$83K - $120K/yr
... Rac audits, and pre-payment reviews. * Idt Collaboration & Care Meetings: Facilitate ... Thorough knowledge of Cms Rai guidelines, Medicare Pps/Obra scheduling, and federal/state long-term ...
MDS Specialist RN
$83K - $120K/yr
... RAC audits, and pre-payment reviews. * IDT Collaboration & Care Meetings: Facilitate ... Thorough knowledge of CMS RAI guidelines, Medicare PPS/OBRA scheduling, and federal/state long-term ...
MDS Specialist RN
$83K - $120K/yr
... RAC audits, and pre-payment reviews. * IDT Collaboration & Care Meetings: Facilitate ... Thorough knowledge of CMS RAI guidelines, Medicare PPS/OBRA scheduling, and federal/state long-term ...
MDS Specialist RN
Whippany, NJ · On-site
$83K - $120K/yr
... RAC audits, and pre-payment reviews. * IDT Collaboration & Care Meetings: Facilitate ... Thorough knowledge of CMS RAI guidelines, Medicare PPS/OBRA scheduling, and federal/state long-term ...
MDS Specialist RN
Whippany, NJ · On-site
$83K - $120K/yr
... RAC audits, and pre-payment reviews. * IDT Collaboration & Care Meetings: Facilitate ... Thorough knowledge of CMS RAI guidelines, Medicare PPS/OBRA scheduling, and federal/state long-term ...
MDS Director (Registered Nurse)
Brooklyn, NY · On-site
$39.25 - $47.50/hr
Manage ADR responses, audits, and appeals * Track and present Quality Measures * Run Medicare Part ... RAC-CT Certification * Prior leadership experience Benefits * Referral bonuses * Free meals during ...
MDS Director (Registered Nurse)
Brooklyn, NY · On-site
$39.25 - $47.50/hr
Manage ADR responses, audits, and appeals * Track and present Quality Measures * Run Medicare Part ... RAC-CT Certification * Prior leadership experience Benefits * Referral bonuses * Free meals during ...
MDS Director (Registered Nurse)
$140K - $160K/yr
Manage ADR responses, audits, and appeals * Track and present Quality Measures * Run Medicare Part ... RAC-CT Certification * Prior leadership experience Benefits * Referral bonuses * Free meals during ...
Quick apply
MDS Director (Registered Nurse)
$140K - $160K/yr
Manage ADR responses, audits, and appeals * Track and present Quality Measures * Run Medicare Part ... RAC-CT Certification * Prior leadership experience Benefits * Referral bonuses * Free meals during ...
RCM & Compliance Manager
Bronx, NY · On-site
$65K - $80K/yr
... Support payer audits, RAC audits, and internal investigations by preparing documentation ... services, Medicare/Medicaid reimbursement, and value based care models. Qualifications ...
RCM & Compliance Manager
Bronx, NY · On-site
$65K - $80K/yr
... Support payer audits, RAC audits, and internal investigations by preparing documentation ... services, Medicare/Medicaid reimbursement, and value based care models. Qualifications ...
RCM & Compliance Manager
Bronx, NY · On-site
$65K - $80K/yr
... Support payer audits, RAC audits, and internal investigations by preparing documentation ... services, Medicare/Medicaid reimbursement, and value based care models. Qualifications • ...
RCM & Compliance Manager
Bronx, NY · On-site
$65K - $80K/yr
... Support payer audits, RAC audits, and internal investigations by preparing documentation ... services, Medicare/Medicaid reimbursement, and value based care models. Qualifications • ...
RCM & Compliance Manager
Bronx, NY · On-site
Support payer audits, RAC audits, and internal investigations by preparing documentation ... Familiarity with Medicare Part A/B billing, MDS/RUG classifications, and Medicaid reimbursement ...
RCM & Compliance Manager
Bronx, NY · On-site
Support payer audits, RAC audits, and internal investigations by preparing documentation ... Familiarity with Medicare Part A/B billing, MDS/RUG classifications, and Medicaid reimbursement ...
Physician Advisor
Short Hills, NJ · Remote
... Medicare regulations, and payer policies * Support compliance with medical necessity criteria (InterQual, MCG, or equivalent) * Assist with audit preparedness and response, including RAC, MAC, and ...
Physician Advisor
Short Hills, NJ · Remote
... Medicare regulations, and payer policies * Support compliance with medical necessity criteria (InterQual, MCG, or equivalent) * Assist with audit preparedness and response, including RAC, MAC, and ...
Physician Advisor
Short Hills, NJ · Remote
... Medicare regulations, and payer policies * Support compliance with medical necessity criteria (InterQual, MCG, or equivalent) * Assist with audit preparedness and response, including RAC, MAC, and ...
Quick apply
Physician Advisor
Short Hills, NJ · Remote
... Medicare regulations, and payer policies * Support compliance with medical necessity criteria (InterQual, MCG, or equivalent) * Assist with audit preparedness and response, including RAC, MAC, and ...
Physician Advisor
Short Hills, NJ · On-site
... Medicare regulations, and payer policies * Support compliance with medical necessity criteria (InterQual, MCG, or equivalent) * Assist with audit preparedness and response, including RAC, MAC, and ...
Physician Advisor
Short Hills, NJ · On-site
... Medicare regulations, and payer policies * Support compliance with medical necessity criteria (InterQual, MCG, or equivalent) * Assist with audit preparedness and response, including RAC, MAC, and ...
Physician Advisor
Short Hills, NJ · On-site
... Medicare regulations, and payer policies * Support compliance with medical necessity criteria (InterQual, MCG, or equivalent) * Assist with audit preparedness and response, including RAC, MAC, and ...
Physician Advisor
Short Hills, NJ · On-site
... Medicare regulations, and payer policies * Support compliance with medical necessity criteria (InterQual, MCG, or equivalent) * Assist with audit preparedness and response, including RAC, MAC, and ...
Assistant MDS Director RN
Manhattan, NY · On-site
$140K/yr
Monitor Medicare and managed care documentation requirements * Assist in preparing for audits and ... RAC-CT certification preferred * Strong knowledge of Medicare, PPS, PDPM, and CMS regulations
Assistant MDS Director RN
Manhattan, NY · On-site
$140K/yr
Monitor Medicare and managed care documentation requirements * Assist in preparing for audits and ... RAC-CT certification preferred * Strong knowledge of Medicare, PPS, PDPM, and CMS regulations
Monitor Medicare and managed care documentation requirements * Assist in preparing for audits and ... RAC-CT certification preferred * Strong knowledge of Medicare, PPS, PDPM, and CMS regulations
Quick apply
Monitor Medicare and managed care documentation requirements * Assist in preparing for audits and ... RAC-CT certification preferred * Strong knowledge of Medicare, PPS, PDPM, and CMS regulations
Assistant MDS Director RN
Manhattan, NY · On-site
$140K/yr
Monitor Medicare and managed care documentation requirements * Assist in preparing for audits and ... RAC-CT certification preferred * Strong knowledge of Medicare, PPS, PDPM, and CMS regulations
Assistant MDS Director RN
Manhattan, NY · On-site
$140K/yr
Monitor Medicare and managed care documentation requirements * Assist in preparing for audits and ... RAC-CT certification preferred * Strong knowledge of Medicare, PPS, PDPM, and CMS regulations
MDS Director
$35.50 - $45.25/hr
Coordinate the timely completion of all OBRA, Medicare, Medicaid, PPS, IPA, Significant Change ... Conduct routine MDS audits to ensure coding accuracy. * Review Quality Measures (QMs) and Quality ...
Quick apply
MDS Director
$35.50 - $45.25/hr
Coordinate the timely completion of all OBRA, Medicare, Medicaid, PPS, IPA, Significant Change ... Conduct routine MDS audits to ensure coding accuracy. * Review Quality Measures (QMs) and Quality ...
Medicare Rac Audit information
See New York salary details
$13.94 - $15.68
4% of jobs
$15.68 - $17.43
7% of jobs
$18.97 is the 25th percentile. Wages below this are outliers.
$17.43 - $19.17
15% of jobs
$19.17 - $20.92
19% of jobs
The median wage is $21.38 / hr.
$20.92 - $22.66
18% of jobs
$22.66 - $24.41
9% of jobs
$24.89 is the 75th percentile. Wages above this are outliers.
$24.41 - $26.16
10% of jobs
$26.16 - $27.90
6% of jobs
$27.90 - $29.65
3% of jobs
$29.65 - $31.39
3% of jobs
$31.39 - $33.14
5% of jobs
$13
$22
$33
How much do medicare rac audit jobs pay per hour?
As of Aug 16, 2026, the average hourly pay for medicare rac audit in New York is $22.75, according to ZipRecruiter salary data. Most workers in this role earn between $18.94 and $25.53 per hour, depending on experience, location, and employer.
What is a Medicare RAC Audit?
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.
What are the typical daily responsibilities for someone working in Medicare RAC Audit?
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.
What are the key skills and qualifications needed to thrive in the Medicare RAC Audit position, and why are they important?
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.
What are the most commonly searched types of Medicare Rac Audit jobs in New York?
The most popular types of Medicare Rac Audit jobs in New York are:
What are popular job titles related to Medicare Rac Audit jobs in New York?
For Medicare Rac Audit jobs in New York, the most frequently searched job titles are:
What job categories do people searching Medicare Rac Audit jobs in New York look for?
The top searched job categories for Medicare Rac Audit jobs in New York are:
$83K - $120K/yr
Full-time, Part-time
Medical, Dental, Vision, Life, Retirement, PTO
Re-posted 29 days ago
CareOne rating
6.8
Based on 30 frontline employees who took The Breakroom Quiz
49th of 242 rated social care providers
Job description
Balance Life & Work with a New Career Opportunity
SKILLED NURSING
Now Hiring - Lead MDS/Clinical Reimbursement Coordinator - Morristown, NJ
CareOne at Madison
Salary Range $83,000 to $120,000
Lead MDS/Clinical Reimbursement Coordinator will be responsible for, but not limited to:
- MDS/RAI Process Leadership: Direct the timely and accurate completion of the Minimum Data Set (MDS) and Care Area Assessments (CAAs) in strict compliance with CMS regulations.
- PDPM & Reimbursement Strategy: Strategically schedule ARDs and audit clinical documentation to capture true resident acuity, optimizing PDPM components, nursing tiers, and NTA scores.
- Quality Measure & Five-Star Optimization: Analyze Casper reports and partner with the DON/IDT to monitor clinical triggers, drive root-cause corrections, and safeguard the facility's Five-Star rating.
- Interdisciplinary Care Planning: Oversee the development of individualized resident Care Plans that support MDS coding, establish clear goals, and satisfy all regulatory requirements.
- Utilization Review & Triple-Check Coordination: Lead the weekly Utilization Review (UR) and Triple-Check meetings, collaborating with therapy, nursing, and the business office to validate medical necessity, track managed care authorizations, and ensure accurate billing alignment prior to transmission.
- Audit Readiness & Compliance: Systematically audit clinical records (MARs/TARs/physician orders) to defend data integrity against ADRs, MAC/RAC audits, and pre-payment reviews.
- IDT Collaboration & Care Meetings: Facilitate interdisciplinary meetings to ensure seamless care integration and reimbursement alignment.
Position Requirements:
- Licensure: Current, unrestricted Registered Nurse (RN) license in the state of practice.
- MDS Experience: 1-3 years of dedicated MDS experience preferred; or an experienced LTC RN with strong clinical and analytical skills who can be trained.
- Regulatory Expertise: Thorough knowledge of CMS RAI guidelines, Medicare PPS/OBRA scheduling, and federal/state long-term care regulations.
- Clinical Knowledge: Strong understanding of general, rehabilitative, and restorative nursing practices, including comprehensive care planning.
- Software Proficiency: Skilled in Microsoft Windows applications; experience with PointClickCare (PCC) and NetHealth is highly preferred.
- Operational Skills: Exceptional attention to detail with a proven ability to complete assessments accurately and within strict regulatory deadlines.
- Autonomy & Flexibility: Ability to work independently and adjust scheduling to support crucial month-end financial close procedures.
The CareOne mission is to define excellence within the health care community. We are dedicated to Maximizing Patient Outcomes. We treat Residents, their families and each other with respect, dignity and compassion. Through a collaborative and consultative approach, we strive to provide a framework of strength and stability for our Centers and Communities. We work to maintain the highest standards of care and service for Residents, families and our valued employees.
We are proud to Offer the following benefits to Part-time (22.5+ hours/week) and Full-time Employees:
- Comprehensive Healthcare Benefits
- Multiple Medical Plans
- Including Pharmacy
- Including Teladoc
- Multiple Dental Plans
- Vision Plan
- Health Savings Account (eligibility restrictions apply)
- Flexible Spending Accounts
- Voluntary Life and AD&D
- Short-Term and Long-Term Disability Plans
- Hospital Indemnity Insurance
- Critical Illness Insurance
- Accident Insurance
- Whole Life Insurance
- Medicare Employee Assistance
- Legal Plan
- Commuter Benefits
- 401k Retirement Plan
- Employee Assistance Program (available to all employees)
- Paid Time Off
- Vacation
- Sick Plans in accordance with state laws
- Opportunities to advance and grow your career
If working with people who are dedicated, compassionate, and concerned about their patients is essential to you, then you'll appreciate being a part of our team. We've built a strong reputation on the outstanding level of care that we provide. We have a graciously appointed facility with strong belief in patient care and service; join us at our beautiful facility!
We are an Equal Opportunity Employer
EEO/AA/M/F/DV
About CareOne
Sourced by ZipRecruiter
CareOne is a leading healthcare corporation specializing in senior care, rehabilitation, and assisted living services. Based in Fort Lee, New Jersey, CareOne was established to meet the healthcare requirements of seniors across the state and has expanded its footprint over the years. With its dedication to excellence, CareOne provides a comprehensive range of medical and healthcare services, including post-acute care, long-term and assisted living, memory care, respite care, and more.
Industry
Health care and social assistance
Company size
10,000+ Employees
Headquarters location
Fort Lee, NJ, US
Year founded
1999