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Rac Auditor Jobs (NOW HIRING)

PF Concepts

Inpatient Coding Auditor

Paterson, NJ · Remote

$40 - $44/hr

Support external audits and payer requests (e.g., RAC/DRG audits) and assist with appeal support ... auditing/DRG validation experience preferred. * Expert knowledge of ICD-10-CM, ICD-10-PCS, MS-DRGs ...

Baptist Health Care

Hospital Coding Auditor

Pensacola, FL · On-site

$25.75 - $29.25/hr

The Coding Auditor reviews/audits patient records for correct ICD-10-CM/PCS codes, CPT Codes, POA ... This position may audit accounts for ER Charging accuracy and perform RAC and other third party ...

Baptist Health Care

Hospital Coding Auditor

Pensacola, FL · On-site

$24 - $27.25/hr

The Coding Auditor reviews/audits patient records for correct ICD-10-CM/PCS codes, CPT Codes, POA ... This position may audit accounts for ER Charging accuracy and perform RAC and other third party ...

Baptist Health Care

Hospital Coding Auditor

Pensacola, FL

$25.75 - $29.25/hr

The Coding Auditor reviews/audits patient records for correct ICD-10-CM/PCS codes, CPT Codes, POA ... This position may audit accounts for ER Charging accuracy and perform RAC and other third party ...

Baptist Health Care

Hospital Coding Auditor

Pensacola, FL · On-site

$24 - $27.25/hr

The Coding Auditor reviews/audits patient records for correct ICD-10-CM/PCS codes, CPT Codes, POA ... This position may audit accounts for ER Charging accuracy and perform RAC and other third party ...

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 Jul 12, 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.

What is a RAC auditor?

A RAC (Recovery Audit Contractor) auditor is a professional responsible for reviewing healthcare claims to identify and recover improper payments made by Medicare or other insurance programs. They analyze billing data, ensure compliance with regulations, and often work for government agencies or contractors to improve billing accuracy and reduce fraud. Strong knowledge of healthcare coding, billing practices, and audit procedures is essential for this role.

How to prepare for a RAC audit?

A RAC auditor reviews healthcare claims for compliance with Medicare rules. To prepare, ensure accurate documentation, verify coding accuracy, and review recent audit guidelines. Familiarity with Medicare policies and maintaining organized records can 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 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 is a RAC audit salary?

A RAC auditor's salary typically ranges from $50,000 to $80,000 annually, depending on experience, location, and certifications. They often work in healthcare or insurance settings, reviewing claims and ensuring compliance, with some roles offering additional benefits or bonuses.

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
Infographic showing various Rac Auditor job openings in the United States as of July 2026, with employment types broken down into 83% Full Time, 14% Part Time, 2% Contract, and 1% Nights. Highlights an 86% Physical, 4% Hybrid, and 10% Remote job distribution, with an average salary of $33,806 per year, or $16.3 per hour.
Medical Review Nurse - CMS/RAC Auditor, Government Audits

Medical Review Nurse - CMS/RAC Auditor, Government Audits

Machinify

Remote

Full-time

Posted 17 days ago

Job description

Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plan clients across the country. Deployed by over 85 health plans, including many of the top 20, and representing more than 270 million lives, Machinify brings together a fully configurable and content-rich, AI-powered platform along with best-in-class expertise. We're constantly reimagining what's possible in our industry, creating disruptively simple, powerfully clear ways to maximize financial outcomes and drive down healthcare costs.
The Medical Review Nurse - CMS / RAC (Government Audits) primarily performs medical claims audit reviews for government clients. As a MR Nurse, you will join a team of experienced medical auditors and coders performing retrospective and prepayment audits on claims for Government Payers. You will work remotely in a fast paced and dynamic environment and be part of a multi-location team.
Please note: RAC certification is preferred for this role. The selected candidate may need to work toward RAC certification if they do not currently have it.
Key Responsibilities:
  • Auditing claims for medically appropriate services provided in both inpatient and outpatient settings while applying appropriate medical review guidelines, policies and rules.
  • Document all findings referencing the appropriate policies and rules.
  • Generate letters articulating audit findings.
  • Supporting your findings during the appeals process if requested.
  • Working collaboratively with the audit team to identify and obtain approval for particular vulnerabilities and/or cases subject to potential abuse.
  • Work in partnership with our clients, CMD colleagues, and other contractors on improving medical policies, provider education, and system edits.
  • Keep abreast of medical practice, changes in technology, and regulatory issues that may affect our clients.
  • Work with the team to minimize the number of appeals; Suggest ideas that may improve audit workflows; Assist with QA functions and training team members.
  • Participate in establishing edit parameters, new issue packets and development of Medical Review Guidelines.
  • Interface with and support the Medical Director and cross train in all clinical departments/areas.
  • Other duties as required to meet business needs.

Knowledge, Skills and Abilities Needed:
  • Experience with utilization management systems or clinical decision-making tools such as Medical Coverage Guidelines (MCG) or InterQual.
  • Experience with and deep knowledge of ICD-9, ICD-10, CPT-4 or HCPCS coding.
  • Knowledge of insurance programs program, particularly the coverage and payment rules.
  • Ability to maintain high quality work while meeting strict deadlines.
  • Excellent written and verbal communication skills.
  • Ability to manage multiple tasks including desk audits and claims review.
  • Must be able to independently use standard office computer technology (e.g. email telephone, copier, etc.) and have experience using a case management system/tools to review and document findings.
  • Must be able to manage multiple assignments effectively, create documentation outlining findings and/or documenting suggestions, organize and prioritize workload
  • Effectively work independently and as a team, in a remote setting.

Required and Preferred Qualifications:
  • Active unrestricted RN license in good standing, is required.
  • Must not be currently sanctioned or excluded from the Medicare program by the OIG.
  • Minimum of five (5) years diversified nursing experience providing direct care in an inpatient or outpatient setting.
  • One (1) or more years' experience performing medical records review.
  • One (1) or more years' experience in health care claims that demonstrates expertise in, ICD-9/ICD-10 coding, HCPS/CPT coding, DRG and medical billing experience for an Insurance Company or hospital required.
  • Strong preference for experience performing utilization review for an insurance company, Tricare, MAC, or organizations performing similar functions.
  • RAC certification preferred.

Equal Employment Opportunity at Machinify
We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender, gender identity or expression, or veteran status. We are proud to be an equal opportunity workplace. Machinify is an employment at will employer. We participate in E-Verify as required by applicable law. In accordance with applicable state laws, we do not inquire about salary history during the recruitment process. If you require a reasonable accommodation to complete any part of the application or recruitment process, please let our recruiters know. See our Candidate Privacy Notice at: https://www.machinify.com/candidate-privacy-notice/

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