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Medicare Rac Audit Jobs in Ohio (NOW HIRING)

LMHS

Compliance Auditor - Inpatient Focus

Newark, OH · On-site

Centers for Medicare and Medicaid Services (CMS), Office of Inspector General (OIG), Ohio Department of Health (ODH), Ohio Department of Medicaid (ODM), and Recovery Audit Contractors (RAC)

Legacy Health Services

MDS Nurse

Cleveland, OH · On-site

$34.75 - $45.25/hr

Ensure accuracy of Medicare, Medicaid, and insurance documentation to support appropriate ... Participate in quality improvement initiatives and audits. * Communicate effectively with nursing ...

lhs

LPN MDS Nurse - LPN MDS Nurse

Cleveland, OH

$34.75 - $45.25/hr

Conduct documentation reviews and audits to ensure accuracy and regulatory compliance. * Educate ... Experience with Medicare, Medicaid, PDPM, and managed care reimbursement. * RAC-CT certification or ...

All JobsMedicare Rac Audit JobsMedicare Rac Audit Jobs in Ohio

Medicare Rac Audit information

See Ohio salary details

$12

$19

$28

How much do medicare rac audit jobs pay per hour?

As of Aug 8, 2026, the average hourly pay for medicare rac audit in Ohio is $19.77, according to ZipRecruiter salary data. Most workers in this role earn between $16.44 and $22.16 per hour, depending on experience, location, and employer.

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 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 most commonly searched types of Medicare Rac Audit jobs in Ohio? The most popular types of Medicare Rac Audit jobs in Ohio are:
What are popular job titles related to Medicare Rac Audit jobs in Ohio? For Medicare Rac Audit jobs in Ohio, the most frequently searched job titles are:
What job categories do people searching Medicare Rac Audit jobs in Ohio look for? The top searched job categories for Medicare Rac Audit jobs in Ohio are:
Medicare Rac Audit jobs near you
Infographic showing various Medicare Rac Audit job openings in Ohio as of August 2026, with employment types broken down into 83% Full Time, 14% Part Time, 1% Temporary, and 2% Contract. Highlights an 87% Physical, 5% Hybrid, and 8% Remote job distribution, with an average salary of $41,127 per year, or $19.8 per hour.

MDS (Garfield Heights OH)

Palm Tree Recruiters

Garfield Heights, OH • On-site

$32 - $41/hr

Other

Medical, Dental, Vision, Retirement, PTO

Re-posted 17 days ago

Job description

MDS Coordinator (Garfield Heights OH)

Facility in Garfield Heights OH is seeking a dedicated and experienced MDS Coordinator to join our clinical team. The MDS Coordinator is responsible for managing the Resident Assessment Instrument (RAI) process to ensure accurate, timely, and compliant assessments of all residents in our Long-Term Care (LTC) facility. This role is critical for determining resident care needs, developing individualized care plans, and ensuring appropriate Medicare/Medicaid reimbursement.

Key Responsibilities
  • RAI Process Management: Oversee the entire Minimum Data Set (MDS) and Resident Assessment Instrument (RAI) process, ensuring compliance with federal (CMS) and Ohio state regulations.
  • Assessment Scheduling & Completion: Develop and maintain the facility's MDS schedule, coordinating the timely completion and submission of all assessments (admission, quarterly, annual, significant change, and PPS/OBRA).
  • Interdisciplinary Team (IDT) Coordination: Lead and collaborate with the interdisciplinary team (Nursing, Therapy, Social Services, Dietary, etc.) to ensure accurate information is gathered and documented for MDS completion and Care Plan development.
  • Care Planning: Assist the IDT in translating MDS data into comprehensive, individualized, and measurable care plans that meet the residents physical, mental, and psychosocial needs.
  • Reimbursement & Case-Mix: Ensure the MDS coding accurately reflects the resident's condition and services provided to achieve the appropriate Case Mix Group (CMG) and Resource Utilization Group (RUG) scores for accurate reimbursement (Medicare Part A, Medicaid, and managed care).
  • Auditing and Compliance: Perform regular audits of clinical documentation (charts, progress notes, ADL flow sheets, etc.) to verify MDS accuracy and adherence to facility and regulatory standards.
  • Training: Provide education and training to clinical staff on accurate documentation practices related to the RAI process, restorative nursing, and case mix optimization.
Qualifications
  • Licensure: Must be a currently licensed Registered Nurse (RN) or Licensed Practical Nurse (LPN) in the State of Ohio.
  • Experience: Minimum of one (1) year of experience as an MDS Coordinator in a Long-Term Care (LTC) or Skilled Nursing Facility (SNF) setting is highly preferred.
  • Certification: RAC-CT certification (Resident Assessment Coordinator-Certified) is highly desirable, or the ability to obtain certification within [Specific Timeframe, e.g., six months] of employment.
  • Knowledge: Comprehensive understanding of the RAI process, federal and state regulations, Medicare Part A, and Medicaid reimbursement rules, specifically related to the Patient-Driven Payment Model (PDPM).
  • Skills: Excellent organizational, communication, and time-management skills. Proficient with electronic health records (EHR) and MDS software [Specify software if known, e.g., PointClickCare, MatrixCare].
Benefits
  • Competitive salary based on experience.
  • Medical, Dental, and Vision insurance.
  • Paid Time Off (PTO) and holiday pay.
  • 401(k) retirement plan.
  • Continuing education and RAC certification reimbursement opportunities.

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