$141K - $233K/yr
Audit contractor billing and allocations to ensure amounts are in accordance with contract terms ... cost audit recoveries to the Audit Committee. * Establish quality assurance program for the ...
$141K - $233K/yr
Audit contractor billing and allocations to ensure amounts are in accordance with contract terms ... cost audit recoveries to the Audit Committee. * Establish quality assurance program for the ...
$141K - $233K/yr
Audit contractor billing and allocations to ensure amounts are in accordance with contract terms ... cost audit recoveries to the Audit Committee. * Establish quality assurance program for the ...
Assists management in the review of external payer requests including but not limited to third party payers, Medicare Advantage plans, and Recovery Audit Contractor reviews for reconsideration ...
Assists management in the review of external payer requests including but not limited to third party payers, Medicare Advantage plans, and Recovery Audit Contractor reviews for reconsideration ...
Assists management in the review of external payer requests including but not limited to third party payers, Medicare Advantage plans, and Recovery Audit Contractor reviews for reconsideration ...
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Assists management in the review of external payer requests including but not limited to third party payers, Medicare Advantage plans, and Recovery Audit Contractor reviews for reconsideration ...
Assists management in the review of external payer requests including but not limited to third party payers, Medicare Advantage plans, and Recovery Audit Contractor reviews for reconsideration ...
Assists management in the review of external payer requests including but not limited to third party payers, Medicare Advantage plans, and Recovery Audit Contractor reviews for reconsideration ...
Assists management in the review of external payer requests including but not limited to third party payers, Medicare Advantage plans, and Recovery Audit Contractor reviews for reconsideration ...
Assists management in the review of external payer requests including but not limited to third party payers, Medicare Advantage plans, and Recovery Audit Contractor reviews for reconsideration ...
San Bernardino, CA · On-site
$74K - $91K/yr
... Recovery Audit Contractor (RAC) processes, and billable components pertinent to LLUH Client agreements. Proficient knowledge of charge master components (CPT codes, HCPC's, Revenue codes, Cost ...
San Bernardino, CA · On-site
$74K - $91K/yr
... Recovery Audit Contractor (RAC) processes, and billable components pertinent to LLUH Client agreements. Proficient knowledge of charge master components (CPT codes, HCPC's, Revenue codes, Cost ...
Act as physician representation supporting the organization in reviewing and refuting regulatory reviews for Inpatient medical necessity (e.g., Recovery Audit Contractor (RAC), Quality Improvement ...
Act as physician representation supporting the organization in reviewing and refuting regulatory reviews for Inpatient medical necessity (e.g., Recovery Audit Contractor (RAC), Quality Improvement ...
Contractor and utility records * Invoices and restoration cost documentation * GIS and route ... Audit investigative reports and supporting documentation for accuracy and completeness. * Monitor ...
Contractor and utility records * Invoices and restoration cost documentation * GIS and route ... Audit investigative reports and supporting documentation for accuracy and completeness. * Monitor ...
Jonesboro, AR · On-site
Keith in surveys and audits of Reliance Healthcare facilities. • Serve as team member for in-house Recovery Audit Contractor audit for all Reliance healthcare facilities. • Conduct mock survey ...
Jonesboro, AR · On-site
Keith in surveys and audits of Reliance Healthcare facilities. • Serve as team member for in-house Recovery Audit Contractor audit for all Reliance healthcare facilities. • Conduct mock survey ...
Jonesboro, AR · On-site
Keith in surveys and audits of Reliance Healthcare facilities. • Serve as team member for in-house Recovery Audit Contractor audit for all Reliance healthcare facilities. • Conduct mock survey ...
Jonesboro, AR · On-site
Keith in surveys and audits of Reliance Healthcare facilities. • Serve as team member for in-house Recovery Audit Contractor audit for all Reliance healthcare facilities. • Conduct mock survey ...
Clinical Denials and Appeals, Recovery Audit Contractor (RAC), Medicare Two Midnight Rule review, Concurrent denials review and processing, Peer to Peer discussion with payers, and Inpatient ...
Clinical Denials and Appeals, Recovery Audit Contractor (RAC), Medicare Two Midnight Rule review, Concurrent denials review and processing, Peer to Peer discussion with payers, and Inpatient ...
Clinical Denials and Appeals, Recovery Audit Contractor (RAC), Medicare Two Midnight Rule review, Concurrent denials review and processing, Peer to Peer discussion with payers, and Inpatient ...
Clinical Denials and Appeals, Recovery Audit Contractor (RAC), Medicare Two Midnight Rule review, Concurrent denials review and processing, Peer to Peer discussion with payers, and Inpatient ...
Act as physician representation supporting the organization in reviewing and refuting regulatory reviews for Inpatient medical necessity (e.g., Recovery Audit Contractor (RAC), Quality Improvement ...
Act as physician representation supporting the organization in reviewing and refuting regulatory reviews for Inpatient medical necessity (e.g., Recovery Audit Contractor (RAC), Quality Improvement ...
Clinical Denials and Appeals, Recovery Audit Contractor (RAC), Medicare Two Midnight Rule review, Concurrent denials review and processing, Peer to Peer discussion with payers, and Inpatient ...
Clinical Denials and Appeals, Recovery Audit Contractor (RAC), Medicare Two Midnight Rule review, Concurrent denials review and processing, Peer to Peer discussion with payers, and Inpatient ...
Keith in surveys and audits of Reliance Healthcare facilities. • Serve as team member for in-house Recovery Audit Contractor audit for all Reliance healthcare facilities. • Conduct mock survey ...
Keith in surveys and audits of Reliance Healthcare facilities. • Serve as team member for in-house Recovery Audit Contractor audit for all Reliance healthcare facilities. • Conduct mock survey ...
Clinical Denials and Appeals, Recovery Audit Contractor (RAC), Medicare Two Midnight Rule review, Concurrent denials review and processing, Peer to Peer discussion with payers, and Inpatient ...
Clinical Denials and Appeals, Recovery Audit Contractor (RAC), Medicare Two Midnight Rule review, Concurrent denials review and processing, Peer to Peer discussion with payers, and Inpatient ...
Staying current on trends related to medical necessity, DRG and Recovery Audit Contractor (RAC). * Completing other job-related assignments and special projects as directed. ORGANIZATIONAL ...
Staying current on trends related to medical necessity, DRG and Recovery Audit Contractor (RAC). * Completing other job-related assignments and special projects as directed. ORGANIZATIONAL ...
Jonesboro, AR · On-site
Keith in surveys and audits of Reliance Healthcare facilities. • Serve as team member for in-house Recovery Audit Contractor audit for all Reliance healthcare facilities. • Conduct mock survey ...
Jonesboro, AR · On-site
Keith in surveys and audits of Reliance Healthcare facilities. • Serve as team member for in-house Recovery Audit Contractor audit for all Reliance healthcare facilities. • Conduct mock survey ...
Granger, IN · On-site
Staying current on trends related to medical necessity, DRG and Recovery Audit Contractor (RAC). * Completing other job-related assignments and special projects as directed. ORGANIZATIONAL ...
Granger, IN · On-site
Staying current on trends related to medical necessity, DRG and Recovery Audit Contractor (RAC). * Completing other job-related assignments and special projects as directed. ORGANIZATIONAL ...
Miramar, FL · On-site
$17.50 - $23.75/hr
Enters all Recovery Audit Contractor (RAC) reviews into the third-party software. Requests medical records and coordinates the response to the RAC request.- for Hospital billingReviews coding to ...
Miramar, FL · On-site
$17.50 - $23.75/hr
Enters all Recovery Audit Contractor (RAC) reviews into the third-party software. Requests medical records and coordinates the response to the RAC request.- for Hospital billingReviews coding to ...
$61K - $69.8K
0% of jobs
$69.8K - $78.5K
2% of jobs
$78.5K - $87.3K
4% of jobs
$87.3K - $96.1K
7% of jobs
$104.7K is the 25th percentile. Wages below this are outliers.
$96.1K - $104.9K
12% of jobs
$104.9K - $113.6K
14% of jobs
The median wage is $119.8K / yr.
$113.6K - $122.4K
16% of jobs
$122.4K - $131.2K
16% of jobs
$133.8K is the 75th percentile. Wages above this are outliers.
$131.2K - $140K
15% of jobs
$140K - $148.7K
8% of jobs
$148.7K - $157.5K
6% of jobs
$61K
$120.2K
$157.5K
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.
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.
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.

$141K - $233K/yr
Full-time
This job post has expired today. Applications are no longer accepted.
Pay Range:
$141,587.00 - $233,618.00Supervisory Organization:Sr VP and Chief Human Resources OfficerCountry:
United States of AmericaAddress:
1401 PACIFIC AVECity:
DALLAS, TX 75202FLSA:
ExemptProfessionals:
01 - Official Administrator (EEO-4-United States of America), 1A - Officials and Executives (EEO-SubCategory)General Summary:
Reporting to the DART Board Audit Committee, the Chief Audit Officer oversees, manages, reviews and is responsible for the personnel involved in audit functions performed in accordance with DART Internal Audit departmental policies and procedures. This work includes operational audits, IT outsourced audits, incurred cost audits of contractors, and proactive work. The work will be Committee of Sponsoring Organizations of the Treadway Commission (COSO) based to give management and the Board reasonable assurance as to the ability to achieve Agency objectives.Essential Duties and Responsibilities:
ESSENTIAL DUTIES AND RESPONSIBILITIES:
Develop annual audit plan based on risk, using risk assessment process and model. The audit plan will be approved by the Audit Committee.
The audit process focus will be on business objectives, risks to achievement of objectives, and risk mitigation controls (COSO process). Audit reports are presented to the Audit Committee.
Evaluate management action plans for satisfactory disposition of audit observations. Follow up will be done to ensure completion of action plans.
Assist management in design of internal controls within new or significantly modified processes and systems which may present a high level of risk to the Agency.
Audit contractor billing and allocations to ensure amounts are in accordance with contract terms and Federal Acquisition Regulations (FAR).
Issue quarterly status reports on audit plan & budget approved by the Audit Committee, action plan follow up, and incurred cost audit recoveries to the Audit Committee.
Establish quality assurance program for the department and have quality assurance peer review done every five (5) years to ensure the Internal Audit department complies with standards for the Professional Practice of Internal Auditing.
Develop departmental annual budget to be approved by the Audit Committee.
Interview, select, develop, evaluate, counsel and, if necessary, terminate audit staff.
Identify, evaluate, and recommend opportunities for cost optimization and revenue enhancement through independent audits and advisory engagements, ensuring alignment with organizational objectives and responsible fiscal stewardship.
Provide independent oversight of the organization's fraud risk management framework, ensuring effective controls, prevention strategies, and investigative processes are in place to safeguard assets and uphold organizational integrity.
Performs other related duties as assigned.
MINIMUM KNOWLEDGE, SKILLS, AND ABILITIES REQUIRED:
Note: An equivalent combination of related education and experience may be substituted for the below stated minimums excluding High School Diploma, GED, Licenses, or Certifications.
Bachelor's degree from an accredited college or university in Accounting, Finance or related field.
Eight (8) years progressively responsible audit experience to include a minimum of seven (7) years experience in the use of current auditing "best practices" including risk management, audit planning techniques, and effective and efficient methods to examine, verify and analyze records and creating a highly skilled, motivated staff with strong work ethics and integrity and eight (8) years as a Director or Manager in a medium to large governmental, corporate, or non-profit organization.
Must have a Certified Public Accountant (CPA) or Certified Internal Auditor (CIA) or Certified Information Systems Auditor (CISA) or Certified Fraud Examiner (CFE) designation.
Must understand COSO principles of auditing to the business objectives, risks to achieving those objectives and controls to mitigate such risks and drive the audit function to be COSO based.
Possesses sufficient knowledge of rules and regulations governing multi modal public transit agencies to include FTA, Federal/State Transportation Departments, Public Safety, Procurement and Contracting, Human Resources practices, Public Funding and Finance (not inclusive).
Pass a physical (medical) examination that includes a drug screen in order to operate DART non-revenue vehicles.
Knowledge of budget development/analysis, and operational cost factors.
Knowledge of departmental policies and procedures.
Proficiency on PC and knowledgeable of software applications, including proficiency in Trapeze, Lawson, Ripplestone, Tableau, Microsoft Office applications of Word and Excel or other related software applications.
Analytical and creative skills to find solutions to complex interpersonal, technical and administrative problems.
Ability to be dedicated to meeting the expectations and requirements of internal and external customers; acts with customers in mind; establishes and maintains effective relationships with customers and gains their trust and respect.
Ability to blend people into teams when needed. Creates strong morale and spirit in his/her team. Fosters open dialogue. Defines success in terms of the whole team. Creates a feeling of belonging in the team.
Ability to write clearly and succinctly in a variety of communication settings and styles; can get messages across that have the desired effect.
Ability to marshal resources to get things done; uses resources effectively and efficiently; can orchestrate multiple activities at once to accomplish a goal.
Ability to use rigorous logic and methods to solve difficult problems with effective solutions; can see hidden problems.
Ability to quickly develop technical understanding; is good at learning new industry, company or technical knowledge.
Ability to accurately scope out length and difficulty of tasks and projects.
Sets objectives and goals. Breaks down work into the process steps. Develops schedules and task/people assignments. Anticipates and adjusts for problems and roadblocks. Measures performance against goals. Evaluates results.
Ability to read a situation quickly. Good at focused listening. Can effectively negotiate difficult agreements and settle disputes equitably. Can find common ground and get cooperation with minimum noise.
WORKING CONDITIONS:
Works in an environment where there is minimum exposure to dust, noise, or temperature. May be moderately exposed to unpleasant working conditions to include dust, noise, temperature, weather, petroleum products, and chemicals while visiting DART's operating facilities, assuming incumbent is observing all policies and procedures, safety precautions and regulations, and using all protective clothing and devices provided.
Note:The above statements are intended to describe the general nature and level of work being performed by people assigned to this job. The statements are not intended to be an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. All employees may perform other duties as assigned.
For more information or to submit a cover letter and resume, please contact Gregg A. Moser at gmoser@kapartners.com
DART is proud to be an Equal Employment Opportunity Employer, supporting diversity in the workplace. M/F/D/V
Open until qualified applicants are identified.
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Transportation and warehousing and trucking
201 - 500 Employees
Eagan, MN, US