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Part Time 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 ...

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

Convent Station, 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 ...

$17.25 - $23.25/hr

... Medicare, Medicare Advantage, and commercial payer audits • Prior demand package review or ... RAC, UPIC, or commercial payer audit response • Multi-state Medicaid policy interpretation • ...

MDS Coordinator (SNF)

Clovis, NM · On-site

$41 - $48.08/hr

... Medicare amp; Medicaid Services (CMS). This role ensures accurate clinical documentation ... Conduct chart audits to ensure documentation supports coding * Lead interdisciplinary care plan ...

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Part Time Medicare Rac Audit information

What is the difference between Part Time Medicare Rac Audit vs Part Time Medicare Claims Processor?

AspectPart Time Medicare Rac AuditPart Time Medicare Claims Processor
Required CredentialsKnowledge of RAC audit procedures, Medicare regulationsUnderstanding of claims processing, coding, Medicare policies
Work EnvironmentRemote or office-based, audit-focusedOffice or remote, claims review and data entry
Employer & Industry UsageHealthcare auditing firms, Medicare contractorsHospitals, insurance companies, healthcare providers

While both roles involve Medicare, Part Time Medicare RAC Auditors focus on reviewing and auditing claims for compliance, whereas Part Time Medicare Claims Processors handle the processing and data entry of claims. The roles differ mainly in their focus—auditing versus claims processing—though both require knowledge of Medicare policies and can be performed remotely or in-office.

More about Part Time Medicare Rac Audit jobs
What cities are hiring for Part Time Medicare Rac Audit jobs? Cities with the most Part Time Medicare Rac Audit job openings:
What are the most commonly searched types of Medicare Rac Audit jobs? The most popular types of Medicare Rac Audit jobs are:
What states have the most Part Time Medicare Rac Audit jobs? States with the most job openings for Part Time Medicare Rac Audit jobs include:
Infographic showing various Part Time Medicare Rac Audit job openings in the United States as of May 2026, with employment types broken down into 3% Full Time, 94% Part Time, and 3% Contract. Highlights an 90% Physical, 1% Hybrid, and 9% Remote job distribution.
MDS Specialist RN

MDS Specialist RN

CareOne

Whippany, NJ • On-site

$83K - $120K/yr

Full-time, Part-time

Medical, Dental, Vision, Life, Retirement, PTO

This job post has expired today. Applications are no longer accepted.


CareOne rating

6.9

Company rating: 6.9 out of 10

Based on 29 frontline employees who took The Breakroom Quiz

44th of 228 rated social care providers


Job description

Job Description
Balance Life & Work with a New Career Opportunity
Now Hiring - Lead MDS/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.

About Us
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

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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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