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Rac Auditor Jobs (NOW HIRING)

Pacs

$90K - $120K/yr

General Purpose Reporting to the Senior Director of Clinical Audit, the Clinical Compliance Auditor ... RAC-CT preferred. * Prior experience conducting audits and or conducting internal investigations ...

WVU Medicine

Professional Coding Auditor-Educator

$28 - $31.75/hr

Includes, but not limited to, RAC denials, insurance/3rd party payor denials, etc. 12. Communicates ... auditing techniques required. 3. Must possess the ability to mentor, educate and train others. 4. ...

WVU Medicine

Professional Coding Auditor-Educator

$28 - $31.75/hr

Includes, but not limited to, RAC denials, insurance/3rd party payor denials, etc. 12. Communicates ... auditing techniques required. 3. Must possess the ability to mentor, educate and train others. 4. ...

WVU Medicine

Professional Coding Auditor-Educator

$28 - $31.75/hr

Includes, but not limited to, RAC denials, insurance/3rd party payor denials, etc. 12. Communicates ... auditing techniques required. 3. Must possess the ability to mentor, educate and train others. 4. ...

9580

Compliance Audit Manager, Health Systems

Dallas, TX · On-site

... RAC, OIG, MAC, and other federal/state agencies), ensuring timely and accurate submission of ... Manages auditing of reimbursement issues for UTSW health care providers and entities, including the ...

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How much do rac auditor jobs pay per hour?

As of Jun 11, 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

Clinical Compliance Auditor II - Behavioral Health

PACS

Farmington, UT • On-site

$90K - $120K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

This job post has expired 1 day ago. Applications are no longer accepted.

Job description

General Purpose
Reporting to the Senior Director of Clinical Audit, the Clinical Compliance Auditor II is an advanced-level compliance professional responsible for conducting comprehensive clinical audits of clinical documentation, regulatory compliance practices, and reimbursement related processes related to Skilled Nursing Facilities and related post-acute care settings. This position will promote strong, compliant, and values-aligned culture. The role ensures adherence to federal, state, and local regulations including CMS requirements, supports quality improvement initiatives, and promotes accurate clinical documentation and billing practices.
Essential Duties
  • Complete internal audits related to billing and reimbursement accuracy, documentation integrity, therapy utilization and coding, quality and clinical documentation.
  • Analyze audit findings to identify trends and root causes.
  • Partner with operations and clinical operations to implement corrective action plans and ensure timely follow-up.
  • Conduct and or partner on compliance investigations, ensuring completed timely, objectively and well documented.
  • Deliver live and virtual training sessions in collaboration with operations and clinical operations.
  • Cross functional collaboration across the organization, including (but not limited to) operations, clinical operations, finance, HR and IT teams.
  • Provide regular updates on investigation and audit results and prepare reports.

Qualification and Experience
  • Active License in Physical Therapy (PT), Occupational Therapy (OT), Speech Language Pathology (SLP), or Nursing (RN) or related clinical discipline.
  • A bachelor's degree, required. Master's degree, preferred.
  • 5+ years of increasing levels of responsibility in compliance and/or skilled nursing facilities, specifically with behavioral health auditing.
  • A deep understanding and application of Medicare and Medicaid documentation, coding and regulations.
  • AAPC, AHIMA or HCCA Coding certification and or Auditing/Compliance certification (CPC, CCS, CCS-P, COC, CPMA, CHC) preferred. RAC-CT preferred.
  • Prior experience conducting audits and or conducting internal investigations, in a healthcare setting.
  • Ensures compliance with regulations and controls by examining and analyzing records, reports, operating practices, and documentation; recommends opportunities to strengthen the internal control structure.
  • Demonstrated regional and/or compliance oversight experience supporting multiple healthcare sites.
  • Strong analytical capabilities, excellent communication, attention to detail, and ability to work in a dynamic, fast-paced setting.

What is expected of you at this level
  • Ability to carry out responsibilities with minimal supervision.
  • Apply advanced knowledge and understanding of concepts, principles, and technical capabilities to manage audits and investigations.
  • Possesses strong attention to detail.
  • Ability to effectively prioritize and execute tasks in a fast-paced, dynamic environment.
  • Excellent time management, personal integrity and ability to maintain confidentiality.

Physical Demands
  • Primarily sedentary role with extended periods of computer work.
  • Occasional standing, walking, and light lifting (up to 10-20 lbs).
  • Regular use of hands for typing and office equipment.
  • Ability to read and review detailed documents.
  • Clear verbal and written communication required.
  • Occasional travel based on business needs.

Work location
  • This role is remote, requiring less than 25% travel.

Pay Range: $90,000 - $120,000 annually depending on experience
Join PACS: Elevate Healthcare with Us!
PACS is elevating healthcare by revolutionizing our approach to leadership and quality care. Guided by our core values of love, excellence, trust, accountability, mutual respect, and commitment, we strive to foster a culture of compassionate care within our teams and the communities we serve. As we grow rapidly, exciting opportunities await you to engage in impactful projects and contribute valuable insights to stakeholders nationwide.
If you're ready to make a difference and embrace our mission of creating real change, we invite you to join us at PACS. Together, let's shape the future of healthcare!
Join Our Team and Thrive!
At PACS, we believe our employees are our greatest asset. That's why we offer an exceptional benefits package designed to enhance your well-being and support your lifestyle.
Our Comprehensive Benefits Include
  • Health Coverage: Enjoy medical, dental, and vision plans to keep you and your family healthy.
  • PTO and Vacation: Benefit from generous paid time off and holidays to relax and recharge.
  • Financial Wellness: Take advantage of Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA) to manage your healthcare expenses effectively.
  • Retirement Planning: Secure your future with our 401(k) plan, complete with company contributions to help you build your retirement savings.
  • Support When You Need It: Our Employee Assistance Plan (EAP) provides confidential support for personal and professional challenges.

Join us at PACS and take advantage of a workplace that truly values you!
We celebrate diversity and are committed to creating an inclusive environment for all employees. We welcome applicants of every race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, and any other protected characteristic. Employment decisions are based on qualifications, merit, and business needs.

About PACS

Sourced by ZipRecruiter

Industry

Health care and social assistance

Company size

201 - 500 Employees

Headquarters location

Farmington, UT, US

Year founded

2013

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