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Rac Auditor Jobs (NOW HIRING)

LMHS

Compliance Auditor - Inpatient Focus

Newark, OH · On-site

... RAC). * Communicate with external agencies regarding audits. * Responsible for auditing charge ... capture processes, coding and billing processes, and assisting in resolution of case or system ...

ThedaCare

Coding Auditor

Appleton, WI · On-site

$26.50 - $30.25/hr

The Coding Auditor performs coding quality audits of records to ensure appropriateness and accurate ... RAC, HRSA, and PERM to ensure appropriate reimbursement. Reviews internal processes to ensure ...

Thedacare

Coding Auditor

Manchester, IA

$24.50 - $28/hr

The Coding Auditor performs coding quality audits of records to ensure appropriateness and accurate ... RAC, HRSA, and PERM to ensure appropriate reimbursement. Reviews internal processes to ensure ...

ThedaCare

Coding Auditor

Appleton, WI · On-site

$26 - $29.50/hr

The Coding Auditor performs coding quality audits of records to ensure appropriateness and accurate ... RAC, HRSA, and PERM to ensure appropriate reimbursement. Reviews internal processes to ensure ...

Morris Hospital

MANAGER CASE MANAGEMENT

Morris, IL · On-site

$93K - $140K/yr

Experience in RAC auditing / review. * DCFS Mandated Reporter Certificate of Completion required. * Personal * Demonstrated ability to manage both clinicians and non-clinicians. * Proven leadership ...

Morris Hospital

MANAGER CASE MANAGEMENT

Morris, IL · On-site

$19.50 - $25/hr

Experience in RAC auditing / review. * DCFS Mandated Reporter Certificate of Completion required. * Personal * Demonstrated ability to manage both clinicians and non-clinicians. * Proven leadership ...

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How much do rac auditor jobs pay per hour?

As of Jul 13, 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.
Consultant - Healthcare Compliance Auditor - HTS

Consultant - Healthcare Compliance Auditor - HTS

Berkeley Research Group

Remote

Full-time

Re-posted 13 days ago

Job description

We do Consulting Differently
The Healthcare Compliance Auditor position is a staff consulting position within the Healthcare Transactions and Strategy (HTS) group. HTS is currently seeking a Healthcare Compliance Auditor at the Consultant level.
HTS performs regulatory, reimbursement, data analytics, and compliance auditing for healthcare providers, healthcare payers and healthcare investors. Compliance audit deliverables include assessment of provider compliance programs and auditing of billing and coding of clinical documents and claims documents. This position requires a highly motivated problem solver with strong analytical ability, solid organizational skills, and a desire to advance within the organization. The work of a Healthcare Compliance Auditor will involve execution of engagement work streams that will primarily involve employing certified coding skills to audit provider claims and provider clinical documentation with a particular focus on government programs such as Medicare and Medicaid. Responsibilities include working with team to develop audit specifications, expert analysis of healthcare claims and supporting documentation, quality control, and development of client deliverables.
The work of a Consultant involves execution of engagement work streams that may be either qualitative or quantitative in nature, and responsibilities include: billing and coding audits, compliance program review, quality control, development of client deliverables, and industry research.
This specific position will require knowledge of medical coding and compliance, and potential candidates must have medical auditing expertise. Job title and compensation to be determined based on qualifications and experience.
Job Responsibilities:
  • Plan and perform medical record audits to determine coding accuracy and compliant claims submission.
  • Develop coding and documentation audit methodology using knowledge of key risk areas in coding and documentation compliance
  • Perform coding and documentation audits, reviewing medical records and charges to ensure compliance with CPT-4/HCPCS and ICD-10-CM coding guidelines and standards, as well as the Centers for Medicare & Medicaid Services (CMS) coverage guidelines
  • Conduct analysis of audit findings to identify trends/problems in coding and documentation and effectively communicates the audit findings and recommended areas for improvement
  • Serve as a subject matter expert on interpretation and application of coding and documentation guidelines
  • Monitor relevant resources, publications, and current government compliance and enforcement activity related to high-risk compliance areas
  • Stay current on coding guidelines.
  • Develop analyses using transactional data and/or financial data
  • Generate client deliverables and make valuable contributions to expert reports
  • Demonstrate creativity and efficient use of relevant software tools and analytical methods to develop solutions
  • Participate in group practice meetings, contribute to business development initiatives and office functions such as staff training and recruiting
  • Prioritize assignments and responsibilities to meet goals and deadlines.

Qualifications:
  • 4-year degree (BS or BA)
  • Active coding certification from either AAPC (CPC, CPMA) or AHIMA (CCC-P, AOC) is required; Do not desire risk adjustment certifications (CRC, RAC) or experience. Do not desire inpatient hospital certifications (CIC, CCS) or experience.
  • Preference will be given to candidates that are certified in medical auditing.
  • 2+ years of work experience with a focus on healthcare provider billing and coding; Less than 10 years preferred.
  • Preference will be given to candidates that are experienced with physician practice coding (e.g. primary care, dermatology, orthopedics, ophthalmology), ASC coding, and/or post-acute coding (e.g. hospice, home health, SNFs).
  • Preference will be given to candidates that have previously worked in a consulting firm environment in which their duties included auditing providers or providing audits associated with transactional diligence.
  • Preference will be given to candidates who have worked in a role at a health plan auditing and reviewing providers in that plan's network.
  • Comprehensive knowledge of Medicare rules, regulations, and guidelines as they apply to coverage, coding, and provider documentation.
  • Advanced knowledge of CPT-4, HCPCS, and ICD-10-CM coding systems, guidelines, and regulatory requirements.

Required skills include:
  • Demonstrated ability to interpret national coding and documentation guidelines and translate them into effective auditing practices and tools; identify issues in coding and documentation practices and recommend corrective action; develop reports, track, and trend audit findings and results.
  • Proficient user in Microsoft Office Suite, specifically Excel, PowerPoint, Access, and Word. A desire to expand those capabilities is required, as is the ability to train others to use such tools.
  • Commitment to producing high quality analysis and attention to detail.
  • Excellent time management, organizational skills, and ability to prioritize work and meet deadlines.
  • Keen interest in healthcare compliance and healthcare policy.
  • Exceptional verbal and written communication skills.
  • Desire to work within a team environment.
  • Candidate must be able to submit verification of their legal right to work in the U.S., without company sponsorship.

Consultant Salary Range: $70,000 - $150,000
Candidate must be able to submit verification of legal right to work in the U.S., without company sponsorship.
About BRG
BRG combines world-leading academic credentials with world-tested business expertise and purpose-built emerging technologies. Our culture centers on agility and connectivity which sets us apart and gets you ahead.
At BRG, our professionals include specialist consultants, industry experts, renowned academics, and leading-edge data scientists. Together, they bring a diversity of real-world experience, data, and human and artificial intelligence, to economics, disputes, and investigations; corporate finance; and performance improvement services that address the most complex challenges facing organizations across the globe.
Our unique structure nurtures the interdisciplinary relationships that give us the edge, laying the groundwork for more informed insights and more original, incisive thinking. When paired with our global reach and resources, our diverse perspectives and technical capabilities make us uniquely capable to address our clients' challenges. We get results because we know how to apply our thinking to your world.
At BRG, we don't just show you what's possible. We're built to help you make it happen.
BRG is proud to be an Equal Opportunity Employer. Our hiring practices provide equal opportunity for employment without regard to race, religion, color, sex, gender, national origin, age, United States military veteran status, ancestry, sexual orientation, marital status, family structure, medical condition including genetic characteristics or information, veteran status, or mental or physical disability so long as the essential functions of the job can be performed with or without reasonable accommodation, or any other protected category under federal, state, or local law.

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