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Rac Auditor Jobs (NOW HIRING)

Torrance Memorial

RN Auditor - FT Days

Torrance, CA

$48.77 - $81.51/hr

RN Auditor Under direct supervision of the Manager, RN Auditor, the RN Auditor is responsible for ... Assists with RAC preparation. Assists in gathering documentation necessary to respond to the ...

Phsorg

$54K - $83K/yr

Remote Hybrid Pro Fee Auditor/Educator Summary: Build your Career. Make a Difference. Presbyterian ... RAC and other audit agency focuses, as well as internal and external risk assessments * Regularly ...

Modernizing Medicine, Inc.

Medical Coding Auditor

Support in the review, appeal and follow-up of third-party (RAC, CERT, etc.) audits * Assist in ... Collaborate with fellow coding/auditing team members to maintain department compliance and ...

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How much do rac auditor jobs pay per hour?

As of Jun 10, 2026, the average hourly pay for rac auditor in the United States is $16.25, according to ZipRecruiter salary data. Most workers in this role earn between $14.42 and $18.27 per hour, depending on experience, location, and employer.

Is it hard to become a medical auditor?

Becoming a medical auditor typically requires a background in healthcare, such as a nursing or medical coding certification, along with knowledge of medical records and billing practices. Many roles also prefer candidates with experience in healthcare compliance or auditing, and some positions may require certification like the Certified Professional Medical Auditor (CPMA). The difficulty depends on your existing qualifications and the specific requirements of the employer.

How to prepare for a RAC audit?

A RAC auditor reviews healthcare claims for compliance and accuracy. To prepare, ensure all documentation is complete, accurate, and organized, including patient records and billing information, and review coding guidelines and policies. Familiarity with audit procedures and maintaining up-to-date certifications can also help facilitate a smooth audit process.

What are some common challenges faced by RAC Auditors when reviewing healthcare claims, and how can they be managed?

RAC Auditors frequently encounter challenges such as navigating complex medical documentation, ensuring compliance with ever-changing regulations, and handling large volumes of claims within tight deadlines. Effective time management, strong attention to detail, and continuous education on regulatory updates are essential for success in this role. Collaborating closely with healthcare providers and maintaining clear communication helps resolve discrepancies and supports accurate claim determinations.

Is an auditor a high paying job?

Auditors can earn competitive salaries, especially with experience, certifications like CPA, and working in specialized industries. Entry-level auditors typically earn less, but salaries increase with seniority and expertise, making auditing a potentially well-paying profession.

What is a RAC audit?

A RAC (Recovery Audit Contractor) audit is a review conducted by government contractors to identify and recover improper Medicare payments. RAC auditors examine healthcare claims and billing practices to ensure compliance with regulations, often using specialized software and data analysis tools. Healthcare providers must maintain accurate documentation to respond effectively to these audits.

What are the key skills and qualifications needed to thrive as a RAC Auditor, and why are they important?

To thrive as a RAC (Recovery Audit Contractor) Auditor, you need a strong background in healthcare compliance, medical coding, billing, and an understanding of Medicare and Medicaid regulations, often supported by certifications such as CPC or CCS. Familiarity with auditing tools, claims management software, and electronic health record (EHR) systems is typically required. Attention to detail, analytical thinking, and effective communication are essential soft skills for accurately reviewing claims and interacting with healthcare providers. These competencies ensure accurate identification of improper payments, regulatory compliance, and minimized financial risk for healthcare organizations.

What are RAC Auditors?

RAC Auditors, or Recovery Audit Contractors, are professionals hired by the Centers for Medicare & Medicaid Services (CMS) to identify and correct improper Medicare payments. Their primary role is to review medical records and billing data to detect overpayments or underpayments to healthcare providers. RAC Auditors help ensure that Medicare funds are used appropriately by recovering funds paid in error and educating providers on proper billing practices. They play a crucial role in maintaining the integrity of the Medicare program.

What is the difference between Rac Auditor vs Rac Investigator?

AspectRac AuditorRac Investigator
CertificationsTypically requires compliance and auditing certificationsOften requires investigative or law enforcement credentials
Work EnvironmentOffice-based, focused on reviewing records and processesField and office-based, involved in interviews and investigations
Employer & IndustryHealthcare, insurance, or corporate sectorsLegal, law enforcement, or regulatory agencies
Search & Comparison IntentUnderstanding audit roles and responsibilitiesUnderstanding investigative procedures and scope

While both roles involve compliance and oversight, a Rac Auditor primarily reviews records and processes to ensure fairness and adherence to policies. In contrast, a Rac Investigator conducts investigations into specific incidents or violations, often involving interviews and evidence collection. The roles differ mainly in scope and approach but share a focus on racial fairness and compliance within their respective environments.

More about Rac Auditor jobs
What are the most commonly searched types of Rac Auditor jobs? The most popular types of Rac Auditor jobs are:
What states have the most Rac Auditor jobs? States with the most job openings for Rac Auditor jobs include:
What job categories do people searching Rac Auditor jobs look for? The top searched job categories for Rac Auditor jobs are:
Rac Auditor jobs near you
Compliance Nurse Auditor

Compliance Nurse Auditor

Baptist Memorial Health Care Corporation

Starkville, MS • On-site

Full-time

Posted 20 days ago

Baptist Memorial Health Care rating

7.3

Company rating: 7.3 out of 10

Based on 110 frontline employees who took The Breakroom Quiz

295th of 870 rated healthcare providers

Job description

Job Summary
Under the direction of Compliance Officer, within Department of Compliance Audit and
Appeals, Nurse Auditor will be responsible for responding to external audits including writing appeals, working
with Medical Staff and other staff. Nurse Auditor will be responsible for facility's communication and
interactions with CMS, Recovery Audit Contractors (RAC) and other third party auditors. Nurse Auditor will
document information and comments into the facilities tracking system to ensure audit deadlines are met.
Nurse Auditor will work with other departments to gather information, conduct internal audits set forth in the
OIG Work Plan and identify "problem areas" within the facility where changes to organizational practices,
policies or procedures might be needed to enhance organizational efficiencies and effectiveness.
Nurse Auditor, together with other members of the department, will prepare and monitor Corrective Action
Plans, conduct education and training and monitor for progress toward improved performance and
compliance. Other duties include conducting audits to identify problems and assisting the CFO as needed
with Healthgrades, MACRA/MIPS, data collection, analysis and ultimately educating physicians for
improvement.
Qualifications:
1. Bachelor's degree in nursing from an accredited program required.
2. Master's Degree in nursing, business or other health care related field preferred.
3. Current Mississippi Registered Nurse License.
4. Relevant Experience in a hospital setting.
5. Strong knowledge of state and federal law and regulations.
6. Understanding of CMS coverage and payment methodologies.
7. Excellent oral and written communication skills.
8. Advanced computer proficiency.
9. Excellent organizational skills and attention to detail.
10. Coding experience preferred.
11. Previous audit experience preferred.
12. Knowledge of InterQual and Principles of Managed Care preferred.

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About Baptist Memorial

Sourced by ZipRecruiter

Baptist Memorial, based in Memphis, TN, US, is a leading health care organization renowned in the healthcare industry. The company's official website is baptistonline.org which provides a comprehensive view of their services and operations. Baptist Memorial operates a myriad of hospitals, health clinics, and medical facilities providing expert and compassionate care. Founded in 1912, it has a rich legacy of over a hundred years of dedication to its community, offering services which include acute care, diagnostic services, and a broad range of speciality health services fulfilling various patient needs.

Industry

Hospitals

Company size

10,000+ Employees

Headquarters location

Memphis, TN, US

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