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
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 ...
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
Assistant MDS Director RN
Manhattan, NY · On-site
$125 - $150/hr
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
$125 - $150/hr
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
Quick apply
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
RCM Lead
Manhattan, NY · On-site
$150 - $200/hr
We've become the fastest growing digital health system matching people with Medicare and their ... You've been on the receiving end of payer or CMS audits (TPE, RAC, MAC, UPIC, or commercial payer ...
RCM Lead
Manhattan, NY · On-site
$150 - $200/hr
We've become the fastest growing digital health system matching people with Medicare and their ... You've been on the receiving end of payer or CMS audits (TPE, RAC, MAC, UPIC, or commercial payer ...
RCM Lead
New York, NY · On-site
$19.75 - $26.25/hr
We've become the fastest growing digital health system matching people with Medicare and their ... You've been on the receiving end of payer or CMS audits (TPE, RAC, MAC, UPIC, or commercial payer ...
Quick apply
RCM Lead
New York, NY · On-site
$19.75 - $26.25/hr
We've become the fastest growing digital health system matching people with Medicare and their ... You've been on the receiving end of payer or CMS audits (TPE, RAC, MAC, UPIC, or commercial payer ...
MDS Director
Linden, NJ · On-site
$125 - $150/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 ...
MDS Director
Linden, NJ · On-site
$125 - $150/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 ...
RCM Lead
New York, NY · On-site
$19.75 - $26.25/hr
We've become the fastest growing digital health system matching people with Medicare and their ... You've been on the receiving end of payer or CMS audits (TPE, RAC, MAC, UPIC, or commercial payer ...
RCM Lead
New York, NY · On-site
$19.75 - $26.25/hr
We've become the fastest growing digital health system matching people with Medicare and their ... You've been on the receiving end of payer or CMS audits (TPE, RAC, MAC, UPIC, or commercial payer ...
MDS Director
Linden, NJ · On-site
$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
Linden, NJ · On-site
$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 ...
NH - Specialist, Performance Improvement (MDS)
Brooklyn, NY · On-site
$36 - $45.75/hr
Monitors and audits clinical records, assures accuracy and timeliness. * Informs PI Director of ... Maintains current working knowledge of Medicare criteria, serving as a resource for nursing staff ...
NH - Specialist, Performance Improvement (MDS)
Brooklyn, NY · On-site
$36 - $45.75/hr
Monitors and audits clinical records, assures accuracy and timeliness. * Informs PI Director of ... Maintains current working knowledge of Medicare criteria, serving as a resource for nursing staff ...
DRG Validator- Remote
Garden City, NY · Remote
$85K/yr
Write clear, accurate, and concise rationales supporting audit findings. Compose physician queries ... and/or RAC Determinations. Provide written recommendations for optimal coding and DRG / SOI ...
DRG Validator- Remote
Garden City, NY · Remote
$85K/yr
Write clear, accurate, and concise rationales supporting audit findings. Compose physician queries ... and/or RAC Determinations. Provide written recommendations for optimal coding and DRG / SOI ...
Manager, Professional Coding Quality & Education, Health Information Management, Full Time
Paramus, NJ · On-site
$100 - $125/hr
The Manager develops and implements coding education, oversees coding quality and audit programs ... ICD-10-CM, ICD-10-PCS, CPT, HCPCS Level II, Medicare, Medicaid, and commercial payer reimbursement ...
Manager, Professional Coding Quality & Education, Health Information Management, Full Time
Paramus, NJ · On-site
$100 - $125/hr
The Manager develops and implements coding education, oversees coding quality and audit programs ... ICD-10-CM, ICD-10-PCS, CPT, HCPCS Level II, Medicare, Medicaid, and commercial payer reimbursement ...
... and audit. * Complete required training and ongoing training to nd maintain system access ... Medicare managed care is preferred. * Assessment-related certification (for example, RAC-CT) is ...
... and audit. * Complete required training and ongoing training to nd maintain system access ... Medicare managed care is preferred. * Assessment-related certification (for example, RAC-CT) is ...
... and audit. * Complete required training and ongoing training to nd maintain system access ... Medicare managed care is preferred. * Assessment-related certification (for example, RAC-CT) is ...
Quick apply
... and audit. * Complete required training and ongoing training to nd maintain system access ... Medicare managed care is preferred. * Assessment-related certification (for example, RAC-CT) is ...
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 Sep 7, 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:
Contractor
Re-posted 11 days ago
Job description
***WE ARE CURRENTLY FULLY STAFFED, BUT OUR NEEDS CAN CHANGE AT ANY TIME,
AND WE ARE STILL ACCEPTING APPLICATIONS***
The Physician Advisor provides physician-to-physician reviews, clinical guidance, education, and escalation support while promoting evidence-based practices and appropriate resource utilization.
Key Responsibilities
Education & Physician Engagement
Qualifications
Required
Preferred
Skills & Competencies
AND WE ARE STILL ACCEPTING APPLICATIONS***
The Physician Advisor provides physician-to-physician reviews, clinical guidance, education, and escalation support while promoting evidence-based practices and appropriate resource utilization.
Key Responsibilities
- Conduct physician-to-physician reviews for medical necessity, level of care, and denial prevention/appeals
- Support utilization review and case management teams with complex clinical decision-making
- Ensure appropriate admission status determinations (inpatient vs. observation) in alignment with CMS and payer guidelines
- Provide clinical oversight related to length of stay, care progression, and discharge planning
- Ensure adherence to CMS Conditions of Participation, 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 commercial payer audits
- Partner with HIM/CDI teams to improve documentation quality and clinical accuracy
Education & Physician Engagement
- Serve as a trusted peer resource to attending physicians and advanced practice providers
- Educate medical staff on regulatory requirements, utilization best practices, and documentation standards
- Support change management initiatives related to clinical operations and compliance
Qualifications
Required
- MD or DO with an active, unrestricted medical license
- Board-certified or board-eligible in a recognized specialty
- Clinical practice experience in an acute care or relevant healthcare setting
- Strong knowledge of utilization management, medical necessity, and payer regulations
- Excellent communication skills with the ability to conduct peer-to-peer discussions
Preferred
- Prior experience as a Physician Advisor, Medical Director, or in Utilization Review
- Familiarity with CMS guidelines, InterQual, MCG, and denial management processes
- Experience working with case management, CDI, HIM, or revenue cycle teams
- Experience in a remote or consulting healthcare environment
Skills & Competencies
- Physician-to-physician negotiation and collaboration
- Clinical judgment balanced with regulatory and financial awareness
- Data-driven decision-making
- Ability to influence without authority
- Strong written and verbal communication