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Recovery Audit Contractor Jobs in Virginia (NOW HIRING)

Riverside

Compliance Analyst RMG

Newport, VA · Remote

$57K - $78K/yr

... payor recovery audits. Uses expertise and discretion to apply necessary corrections to ensure ... and Contracting to resolve the denied claims and provide education to reduce future denials.

HITT Contracting, Inc.

MEP Manager

Falls Church, VA · On-site

$95K - $135K/yr

... and recovery when appropriate. Audit MEP processes and procedures for adherence to program ... HITT Contracting offers a competitive total benefits and compensation package including performance ...

HITT Contracting, Inc.

MEP Manager

Richmond, VA · On-site

$85K - $125K/yr

... and recovery when appropriate. Audit MEP processes and procedures for adherence to program ... HITT Contracting offers a competitive total benefits and compensation package including performance ...

HITT Contracting, Inc.

MEP Manager

Richmond, VA · On-site

$85K - $125K/yr

... and recovery when appropriate. Audit MEP processes and procedures for adherence to program ... HITT Contracting offers a competitive total benefits and compensation package including performance ...

HITT Contracting, Inc.

MEP Manager

Falls Church, VA · On-site

$95K - $135K/yr

... and recovery when appropriate. Audit MEP processes and procedures for adherence to program ... HITT Contracting offers a competitive total benefits and compensation package including performance ...

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Recovery Audit Contractor information

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$60.5K

$119.2K

$156.1K

How much do recovery audit contractor jobs pay per year?

As of Aug 28, 2026, the average yearly pay for recovery audit contractor in Virginia is $119,204.00, according to ZipRecruiter salary data. Most workers in this role earn between $103,100.00 and $135,300.00 per year, depending on experience, location, and employer.

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.

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 are popular job titles related to Recovery Audit Contractor jobs in Virginia?

For Recovery Audit Contractor jobs in Virginia, the most frequently searched job titles are:

What job categories do people searching Recovery Audit Contractor jobs in Virginia look for?

The top searched job categories for Recovery Audit Contractor jobs in Virginia are:

Recovery Audit Contractor jobs near you
Infographic showing various Recovery Audit Contractor job openings in Virginia as of August 2026, with employment types broken down into 90% Full Time, and 10% Contract. Highlights an 96% In-person, and 4% Hybrid job distribution, with an average salary of $119,204 per year, or $57.3 per hour.

Compliance Auditor

Chesapeake, VA • On-site

Chesapeake Regional Healthcare
Health Care and Social Assistance • 1 - 5K employees

6.9

Company rating: 6.9 out of 10

Based on 22 frontline employees who took The Breakroom Quiz

People enjoy working here

Recommended by parents

Respectful managers

Learn more about Chesapeake Regional Healthcareexternal

Full-time

Re-posted 10 days ago

Job description

Position Summary
The Compliance Auditor plans, schedules, and performs comprehensive internal professional fee audits to include routine audits, focused audits, for cause audits and, not for cause audits for Chesapeake Regional Healthcare (CRH) and all of its affiliated entities. Performs detection of documentation, coding, and billing errors as well as collaboration with appropriate stakeholders to ensure corrective action and/or appropriate response to identified issues. Communicates audit results to providers, coders, management, and other appropriate staff. Develops and delivers provider and coder education. Evaluates the effectiveness of internal controls designed to ensure that processes and practices lead to regulatory compliance with guidelines related to professional fee documentation, coding, and billing. Stays abreast of documentation, coding, and billing regulations and standards and serves as a subject matter expert on the interpretation and application of documentation, along with coding rules and regulations.
Essential Duties and Responsibilities
These duties and responsibilities described below represent the general tasks performed on a daily basis; other tasks may be assigned. Essential functions may include, but are not limited to, the functions listed below:
  • Plans, schedules, and performs comprehensive internal professional and hospital fee audits as determined by the Compliance Work Plan to include routine and focused audits.
  • Detection of documentation, coding, and billing errors as well as collaboration with appropriate stakeholders to ensure corrective action and/or appropriate responses are implemented to address identified issues.
  • Communicates audit results to providers, coders, management, and other appropriate staff and makes recommendations to ensure sustained compliance and improvement.
  • Develops and delivers provider and coder education, as needed.
  • Evaluates the effectiveness of internal controls designed to ensure that processes and practices lead to regulatory compliance with guidelines related to professional and hospital fee documentation, coding, and billing, including federal and state regulations, CMS, and OIG compliance standards.
  • Stays abreast of ever-changing documentation, coding, and billing regulations and standards.
  • Serves as subject matter expert on interpretation and application of documentation and coding rules and regulations.
  • Develops compliance auditing plans based on thorough research on studies conducted by government agencies and professional organizations.
  • Compiles reports on the results of external and internal audits and presents these reports to the relevant supervisors and department heads.
  • Performs audits according to the established Compliance Work Plan and calendar and prepares Compliance Work Plan summary slides with appropriate corrective action plans.
  • Assists with the modification of the Compliance Work Plan calendar through the year to include additional audits, based on audit results, risks, and corrective action plans.
  • Assists the Compliance Committee and presents summary of audit activities to the committee.
  • Provides results of audits and education to HIM, Revenue Cycle Departments, physicians, hospital and clinic operations regarding charging, documentation, and billing requirements.
  • Assists departments with development of corrective action plans (CAPs), as needed, and ensures CAPs are implemented and evaluated for effectiveness by performing follow up audits/reviews in a timely manner.
  • Communicates effectively with the Corporate Compliance team and CRH aand all of its affiliated entities departments following the CRH Code of Conduct.
  • Performs medical record audits of documentation, coding and billing for technical and professional services, including: CPT; ICD10; HCPCII; DRG; APC; APG; Modifiers; Non-Physician Practitioner Documentation (including "incident-to" guidelines), and other services;
  • Conducts audits of electronic and manual documentation, coding, and billing systems.
  • Develops formal audit reports of findings and recommendations, which are presented to senior management of applicable department, the Corporate Compliance Committee and Operations Quality and Safety Committee.
  • Participates in external government audits, including but not limited to: Centers for Medicare and Medicaid Services (CMS); Office of Inspector General (OIG); Medicaid Fraud Control Unit (MFCU); Virginia Department of Health (DOH); Medicaid Integrity Program Contractor (MIC); Recovery Audit Contractor (RAC); Zone Program Integrity Contractor (ZPIC); Health Care Fraud Prevention and Enforcement Action Team (HEAT)
  • Participates in development of voluntary disclosures and repayments to federal and state agencies.
  • Conducts opening and closing meetings with senior management of applicable department being audited.
  • Identifies compliance risk areas and develops action plans accordingly.
  • Develops and coordinates analysis of encounter forms and documentation templates.
  • Audits and enforces compliance policies and procedures.
  • Develops and conducts documentation, coding and billing curriculum and education classes for more than 100 physicians, allied health professionals, and coding and billing associates annually.
  • Assists in development of risk areas and audit creation.
  • Assists with distribution of all Medicare and Virginia Department of Health updates and code changes to the appropriate associates.
  • Facilitates responses to compliance-related inquiries (phone, e-mail, in-person).
  • Responsible for other matters as assigned by the Chief Corporate Compliance Officer and/or Corporate Compliance Manager and Auditor.

Ideal Candidate Attributes
The ideal candidate will:
  • Pay close attention to detail and strive for excellence.
  • Possess curiosity for learning CRH's business, products and solutions.
  • Thrive in a dynamic environment by practicing effective time management and prioritization of tasks.
  • Comfortable in making recommendations in compliance, audit, and contractual matters.
  • Effectively assist cross-functional projects to completion.
  • Display strong communication and writing skills.
  • Display excellent judgment and strong organizational skills
  • Possess a willingness and ability to work and coordinate activities across a large number of individuals in various departments.
  • Ability to pass required background checks and clearances.

Additional Responsibilities
  • Conduct special projects as assigned.
  • Perform other job-related duties as necessary or assigned.

Minimum Qualifications and Requirements
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Ability to pass required background checks and clearances.
  • Experience as a coder in a hospital and/or healthcare environment
  • Extensive knowledge of evaluation and management coding, modifiers, provider-based billing, and auditing principles
  • American Academy of Professional Coders (AAPC) coding certification (such as Certified Professional Coder (CPC) or dual CPC and Certified Professional Biller (CPB)) or to obtain within one (1) year of hire
  • An in-depth understanding of the industry's rules, guidelines, and regulations
  • Strong attention to detail, analytical, and statistical skills
  • Strong communication and multitasking skills
  • Dedication to objectivity
  • Experience in healthcare revenue cycle, auditing, clinical operations and/or compliance preferred
  • Knowledge of DRG, CPT, CDM and billing operations
  • Knowledge of hospital department operations
  • Knowledge of and experience with EPIC and Athena electronic medical records
  • Strong Skills with Microsoft products (Excel, Word, and Power Point)
  • Strong verbal and written communication skills

Preferred Qualifications
  • Three (3) years auditing experience in a hospital and/or healthcare environment
  • Auditing certification such as Certified Professional Medical Auditor (CPMA) or other accredited auditing certification
  • Bachelor's degree in Nursing, Healthcare Administration, Business, and/or Accounting
  • Health Care Compliance Association (HCCA) membership and certification

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.
For further information, please review the Know Your Rights notice from the Department of Labor.

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