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On Call Medicare Rac Audit Jobs (NOW HIRING)

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 ...

... RAC Audit requests, ensuring timely appeals, as appropriate, and reporting any identified risks to ... Keeps current with third party regulations with emphasis on Medicare billing, teaching physician ...

... RAC Audit requests, ensuring timely appeals, as appropriate, and reporting any identified risks to ... Keeps current with third party regulations with emphasis on Medicare billing, teaching physician ...

Director MDS - RN

Gainesville, GA · On-site

$34.50 - $41.75/hr

Summary: MDS RAC certified : Manages, directs and coordinates, MDS assessments and completion ... Completes weekly chart audits to assess documentation support for skilled Medicare coverage

Director MDS - RN

Gainesville, GA · On-site

$34.75 - $42/hr

MDS RAC Certified Nurse Manages, directs and coordinates MDS assessments and completion according ... Completes weekly chart audits to assess documentation support for skilled Medicare coverage.

Director MDS - RN

Gainesville, GA · On-site

$34.50 - $41.75/hr

Summary: MDS RAC certified : Manages, directs and coordinates, MDS assessments and completion ... Completes weekly chart audits to assess documentation support for skilled Medicare coverage.

... 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 ...

Denials Manager RN

San Gabriel, CA · On-site

$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 ...

... 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 ...

... 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 ...

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On Call Medicare Rac Audit information

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How much do on call medicare rac audit jobs pay per hour?

As of Jul 14, 2026, the average hourly pay for on call medicare rac audit in the United States is $17.22, according to ZipRecruiter salary data. Most workers in this role earn between $14.42 and $18.99 per hour, depending on experience, location, and employer.
What are the most commonly searched types of Medicare Rac Audit jobs? The most popular types of Medicare Rac Audit jobs are:
MDS Specialist RN

MDS Specialist RN

Care-One

Whippany, NJ • On-site

$83K - $120K/yr

Other

Re-posted 25 days ago


CareOne rating

6.8

Company rating: 6.8 out of 10

Based on 30 frontline employees who took The Breakroom Quiz

46th of 235 rated social care providers


Job description

Balance Life & Work with a New Career Opportunity Now Hiring - LeadMDS/Clinical Reimbursement Coordinator - Whippany, NJ CareOne at Hanover Salary Range $83,000 to $120,000 (Full-time) 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.

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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

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