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Medical Billing Specialist

Costa Mesa, CA · On-site

$25 - $30/hr

The Government Recovery Specialist performs duties associated with Centers for Medicare and Medicaid Services (CMS) Recovery Audit Contractor (RAC) program and other government regulatory and ...

Boston Medical Center

Senior Manager Coding IP OP

Additionally, it manages coding-related Recovery Audit Contractor (RAC) reviews, external coding audits, and coding-related denial responses to secure overall coding accuracy, compliance, and ...

Pennant Services

Denials Management Specialist

$18.50 - $24.50/hr

... Recovery Audit Contractor (RAC), Medicare Administrative Contractor (MAC), Medicaid, managed care, and other payer or regulatory reviews. * Reviews medical records for completeness, accuracy, medical ...

Adventist Health

RN, MDS Coordinator

Sonora, CA · On-site

$41 - $49.50/hr

Assists the Recovery Audit Contractor (RAC) in completion of necessary audits. * Notifies IDT of patient schedule conference and of the Assessment Reference Data (ARD). * Provides new admissions with ...

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How much do recovery audit contractor jobs pay per year?

As of Aug 11, 2026, the average yearly pay for recovery audit contractor in the United States is $120,236.00, according to ZipRecruiter salary data. Most workers in this role earn between $104,000.00 and $136,500.00 per year, depending on experience, location, and employer.

What are some typical challenges faced by recovery audit contractors in their daily work?

Recovery Audit Contractors (RACs) often face the challenge of reviewing large volumes of complex medical billing and patient records, which requires high attention to detail and a strong grasp of both clinical and financial documentation. Navigating evolving healthcare regulations and payer requirements can also be demanding, as guidelines frequently change and can affect audit criteria. In addition, effective communication with healthcare providers—sometimes addressing sensitive payment or compliance issues—is a key part of the job. Overcoming these challenges requires continuous learning and strong organizational skills, but also offers opportunities for problem-solving and professional growth.

What are the key skills and qualifications needed to thrive as a recovery audit contractor, and why are they important?

To thrive as a Recovery Audit Contractor, you need a solid background in healthcare administration, auditing practices, and financial analysis, often supported by a degree in accounting, finance, or health information management. Familiarity with Medicare/Medicaid systems, claims processing software, and certifications such as Certified Professional Medical Auditor (CPMA) or Certified Healthcare Auditor (CHA) are commonly required. Attention to detail, analytical thinking, and effective communication skills help contractors review complex records and discuss findings with stakeholders. These abilities are crucial for accurately identifying payment discrepancies, ensuring compliance, and facilitating productive partnerships with healthcare providers.

What is a recovery audit contractor?

A Recovery Audit Contractor (RAC) job involves reviewing healthcare claims to identify overpayments and underpayments made to providers. RACs work on behalf of government agencies, such as Medicare or Medicaid, to ensure billing accuracy and compliance with regulations. They analyze medical records, coding practices, and financial data to detect errors or fraudulent claims. The goal is to recover improper payments while maintaining fairness in the reimbursement process.

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What cities are hiring for Recovery Audit Contractor jobs? Cities with the most Recovery Audit Contractor job openings:
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Recovery Audit Contractor jobs near you
Infographic showing various Recovery Audit Contractor job openings in the United States as of August 2026, with employment types broken down into 75% Full Time, and 25% Contract. Highlights an 87% In-person, and 13% Hybrid job distribution, with an average salary of $120,236 per year, or $57.8 per hour.

Government Audit Recovery Specialist

Integrated Resources, Inc

Costa Mesa, CA • On-site

$30/hr

Contractor

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

Job description

Job Title: Government Audit Recovery Specialist
Job Location: Costa Mesa, CA, 92626
Job Duration: 03 Months Contract (possible extension)
Pat Rate: $30.00/hr on w2
Position Summary:
  • The Government Recovery Specialist performs duties associated with Centers for Medicare and Medicaid Services (CMS) Recovery Audit Contractor (RAC) program and other government regulatory and enforcement agency audits for documentation and billing compliance.
  • This includes data entry, processing of mail, preparation of audit information, and correspondence with government contractors as needed.
  • This role has a fundamental understanding of the RAC program and other audits for documentation and billing compliance.
  • As an essential role and focal point of all government audit activity, the Government Recovery Specialist is responsible for responding to correspondence from Government Agencies related to Recovery Audit Contractor (RAC), Medicare Administrative Contractor (MAC), Cliented Provider Education (TPE), Comprehensive Error Rate Testing (CERT), Office of Inspector General (OIG), Quality Improvement Organizations (QIO) and other Medicaid, MediCal regulatory auditing body for pre and post payment audits.
  • The Government Recovery Specialist performs duties associated with Centers for Medicare and Medicaid Services (CMS) Recovery Audit Contractor (RAC) program and other government regulatory and enforcement agency audits for documentation and billing compliance. This includes data entry, processing of mail, preparation of audit information, and correspondence with government contractors as needed.
  • This role has a fundamental understanding of the RAC program and other audits for documentation and billing compliance.
  • As an essential role and focal point of all government audit activity, the Government Recovery Specialist is responsible for responding to correspondence from Government Agencies related to Recovery Audit Contractor (RAC), Medicare Administrative Contractor (MAC), Cliented Provider Education (TPE), Comprehensive Error Rate Testing (CERT), Office of Inspector General (OIG), Quality Improvement Organizations (QIO) and other Medicaid, MediCal regulatory auditing body for pre and post payment audits.

Skills:
Required Skills & Experience:
  • 3 years of Medicare billing experience in billing, follow up, in an acute care setting.
  • Experience working on complex projects.
  • 13 years of experience in healthcare acute setting regulatory audits and appeals.
  • Experience with and understanding of CMS billing, payment and reimbursement methodologies.
  • Knowledge of privacy regulations, security regulations, release of information, CMS rules and regulations.
  • Proficiency in Microsoft Office applications (Word, PowerPoint, Excel, Outlook).
Preferred Skills & Experience:
  • 5 years of experience or more in an acute setting.
  • 3 years of experience in healthcare acute setting regulatory audits and appeals.
  • Experience working on government, Recovery Audit Contractor (RAC), Medicare Administrative Contractor (MAC), Cliented Provider Education (TPE), Comprehensive Error Rate Testing (CERT), Office of Inspector General (OIG), and other Medicaid, MediCal and other regulatory audits.
  • 5 years of experience in Medicare billing, follow up, appeals.
  • Knowledge of utilization management process, coding, medical necessity criteria.
  • 3 years of Medicare billing experience in billing, follow up, in an acute care setting
  • Experience working on complex projects
  • 13 years of experience in healthcare acute setting regulatory audits and appeals
  • Experience with and understanding of CMS billing, payment and reimbursement methodologies
  • Knowledge of privacy regulations, security regulations, release of information, CMS rules and regulations
  • Proficiency in Microsoft Office applications (Word, PowerPoint, Excel, Outlook).
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About Integrated Resources

Sourced by ZipRecruiter

Integrated Resources Inc (IRI), based in Edison, NJ, US, is an esteemed player in the staffing solutions industry with a credible presence on their official website irionline.com. Notably, IRI provides a range of professional staffing services including contract, contract-to-hire, and direct hire solutions to a wide spectrum of industries such as healthcare, life sciences, manufacturing, financial, insurance, and others. Since its inception, IRI has been committed to delivering top-talent and optimum solutions to meet its clients' diverse needs.

Industry

Recruiting and staffing services

Company size

51 - 200 Employees

Headquarters location

Edison, NJ, US

Year founded

1996

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