... RAC certification if they do not currently have it. Key Responsibilities: * Auditing claims for ... Effectively work independently and as a team, in a remote setting. Required and Preferred ...
... RAC certification if they do not currently have it. Key Responsibilities: * Auditing claims for ... Effectively work independently and as a team, in a remote setting. Required and Preferred ...
Remote Profee Remote Auditor/Educator
Santa Fe, NM · On-site +1
$57K - $87K/yr
Remote Profee Remote Auditor/Educator Summary: Build your Career. Make a Difference. Presbyterian ... RAC and other audit agency focuses, as well as internal and external risk assessments * Regularly ...
Remote Profee Remote Auditor/Educator
Santa Fe, NM · On-site +1
$57K - $87K/yr
Remote Profee Remote Auditor/Educator Summary: Build your Career. Make a Difference. Presbyterian ... RAC and other audit agency focuses, as well as internal and external risk assessments * Regularly ...
Remote Pro Fee Auditor/Educator
Santa Fe, NM · On-site +1
$54K - $83K/yr
Remote Pro Fee Auditor/Educator Summary: Build your Career. Make a Difference. Presbyterian is ... RAC and other audit agency focuses, as well as internal and external risk assessments * Regularly ...
Remote Pro Fee Auditor/Educator
Santa Fe, NM · On-site +1
$54K - $83K/yr
Remote Pro Fee Auditor/Educator Summary: Build your Career. Make a Difference. Presbyterian is ... RAC and other audit agency focuses, as well as internal and external risk assessments * Regularly ...
Remote Hybrid Pro Fee Auditor/Educator
Albuquerque, NM · On-site +1
$54K - $83K/yr
Remote Hybrid Pro Fee Auditor/Educator Summary: Build your Career. Make a Difference. Presbyterian ... RAC and other audit agency focuses, as well as internal and external risk assessments * Regularly ...
Remote Hybrid Pro Fee Auditor/Educator
Albuquerque, NM · On-site +1
$54K - $83K/yr
Remote Hybrid Pro Fee Auditor/Educator Summary: Build your Career. Make a Difference. Presbyterian ... RAC and other audit agency focuses, as well as internal and external risk assessments * Regularly ...
Inpatient Coding Auditor
Paterson, NJ · Remote
$40 - $44/hr
Remote Job Summary: The Inpatient Coding Auditor is responsible for auditing inpatient coding and ... Support external audits and payer requests (e.g., RAC/DRG audits) and assist with appeal support ...
Inpatient Coding Auditor
Paterson, NJ · Remote
$40 - $44/hr
Remote Job Summary: The Inpatient Coding Auditor is responsible for auditing inpatient coding and ... Support external audits and payer requests (e.g., RAC/DRG audits) and assist with appeal support ...
This is a fully remote position and available if you live in the following states only: AK, AL, AR ... Externally, this position interacts with RAC Auditors and other organizations. MINIMUM ...
This is a fully remote position and available if you live in the following states only: AK, AL, AR ... Externally, this position interacts with RAC Auditors and other organizations. MINIMUM ...
Auditing will include scope of both government and commercial payors including but not limited to RAC, ACHA. Education and Certification Requirements: Associate of Science Required Bachelor of ...
Auditing will include scope of both government and commercial payors including but not limited to RAC, ACHA. Education and Certification Requirements: Associate of Science Required Bachelor of ...
Medical Review Nurse - CMS RAC (Government audits)
Plantation, FL · On-site +1
$25.75 - $33.25/hr
Auditing claims for medically appropriate services provided in both inpatient and outpatient ... Effectively work independently and as a team, in a remote setting. Required and Preferred ...
Medical Review Nurse - CMS RAC (Government audits)
Plantation, FL · On-site +1
$25.75 - $33.25/hr
Auditing claims for medically appropriate services provided in both inpatient and outpatient ... Effectively work independently and as a team, in a remote setting. Required and Preferred ...
Medical Review Nurse - CMS RAC (Government audits)
Plantation, FL · On-site +1
$25.75 - $33.25/hr
Auditing claims for medically appropriate services provided in both inpatient and outpatient ... Effectively work independently and as a team, in a remote setting. Required and Preferred ...
Medical Review Nurse - CMS RAC (Government audits)
Plantation, FL · On-site +1
$25.75 - $33.25/hr
Auditing claims for medically appropriate services provided in both inpatient and outpatient ... Effectively work independently and as a team, in a remote setting. Required and Preferred ...
... attending remote coding sessions with the global coding teams * Help with other daily ... Support in the review, appeal and follow-up of third-party (RAC, CERT, etc.) audits * Assist in ...
... attending remote coding sessions with the global coding teams * Help with other daily ... Support in the review, appeal and follow-up of third-party (RAC, CERT, etc.) audits * Assist in ...
Lead Auditor CRS - Midwest Region
Marietta, GA · Remote
$80K - $102K/yr
Complete at least 10 days of audits per month minimum capacity. #LI-MB1 #LI-Remote A global leader ... CQA, RABQSA, IRCA, RAC, Pharmaceutical GMP Professional Certification (CPGP) * Four years related ...
Lead Auditor CRS - Midwest Region
Marietta, GA · Remote
$80K - $102K/yr
Complete at least 10 days of audits per month minimum capacity. #LI-MB1 #LI-Remote A global leader ... CQA, RABQSA, IRCA, RAC, Pharmaceutical GMP Professional Certification (CPGP) * Four years related ...
Lead Auditor CRS - Midwest Region
Northbrook, IL · Remote
$80K - $102K/yr
Complete at least 10 days of audits per month minimum capacity. #LI-MB1 #LI-Remote A global leader ... CQA, RABQSA, IRCA, RAC, Pharmaceutical GMP Professional Certification (CPGP) * Four years related ...
Lead Auditor CRS - Midwest Region
Northbrook, IL · Remote
$80K - $102K/yr
Complete at least 10 days of audits per month minimum capacity. #LI-MB1 #LI-Remote A global leader ... CQA, RABQSA, IRCA, RAC, Pharmaceutical GMP Professional Certification (CPGP) * Four years related ...
Lead Auditor CRS - Midwest Region
Northbrook, IL · Remote
$80K - $102K/yr
Complete at least 10 days of audits per month minimum capacity. #LI-MB1 #LI-Remote A global leader ... CQA, RABQSA, IRCA, RAC, Pharmaceutical GMP Professional Certification (CPGP) * Four years related ...
Lead Auditor CRS - Midwest Region
Northbrook, IL · Remote
$80K - $102K/yr
Complete at least 10 days of audits per month minimum capacity. #LI-MB1 #LI-Remote A global leader ... CQA, RABQSA, IRCA, RAC, Pharmaceutical GMP Professional Certification (CPGP) * Four years related ...
Lead Auditor CRS - Midwest Region
Marietta, GA · Remote
$80K - $102K/yr
Complete at least 10 days of audits per month minimum capacity. #LI-MB1 #LI-Remote A global leader ... CQA, RABQSA, IRCA, RAC, Pharmaceutical GMP Professional Certification (CPGP) * Four years related ...
Lead Auditor CRS - Midwest Region
Marietta, GA · Remote
$80K - $102K/yr
Complete at least 10 days of audits per month minimum capacity. #LI-MB1 #LI-Remote A global leader ... CQA, RABQSA, IRCA, RAC, Pharmaceutical GMP Professional Certification (CPGP) * Four years related ...
Position Title Lead HIM Hospital Coder/Auditor (In-Patient - Observation) Remote Position Summary ... Expertise in MS-DRG Optimization, APR DRG, RAC/HAC/Core Measures. * Coding accuracy: 95% or better ...
Position Title Lead HIM Hospital Coder/Auditor (In-Patient - Observation) Remote Position Summary ... Expertise in MS-DRG Optimization, APR DRG, RAC/HAC/Core Measures. * Coding accuracy: 95% or better ...
DRG Validator- Remote
Garden City, NY · Remote
$85K/yr
The validator is responsible for auditing inpatient medical records, ensuring the accuracy of ... and/or RAC Determinations. Provide written recommendations for optimal coding and DRG / SOI ...
DRG Validator- Remote
Garden City, NY · Remote
$85K/yr
The validator is responsible for auditing inpatient medical records, ensuring the accuracy of ... and/or RAC Determinations. Provide written recommendations for optimal coding and DRG / SOI ...
We are seeking a detail-oriented and driven Post-Pay Audit Manager to lead a team of auditors ... remote or offshore team management experience. * Solid knowledge of government audit programs (RAC ...
We are seeking a detail-oriented and driven Post-Pay Audit Manager to lead a team of auditors ... remote or offshore team management experience. * Solid knowledge of government audit programs (RAC ...
Director, Post Pay Audit
Cooper City, FL · Remote
Oversee audit processes related to government payers and regulatory programs (e.g., CMS RAC ... Minimum of 7-10 years of experience in post-payment auditing, healthcare reimbursement, or revenue ...
Director, Post Pay Audit
Cooper City, FL · Remote
Oversee audit processes related to government payers and regulatory programs (e.g., CMS RAC ... Minimum of 7-10 years of experience in post-payment auditing, healthcare reimbursement, or revenue ...
This role has a fundamental understanding of the RAC program and other audits for documentation and ... auditing body for pre and post payment audits. Skills: Required Skills & Experience: 3 years of ...
Quick apply
This role has a fundamental understanding of the RAC program and other audits for documentation and ... auditing body for pre and post payment audits. Skills: Required Skills & Experience: 3 years of ...
Physician Audit-Educator (757)
Minot, ND · Remote
$193K - $242K/yr
Respond to payor audits conducted by the CMS RAC contractor, Medicare, Medicaid, as well as all ... May consider remote employee. Licenses and Certifications Required * Certification as a ...
Physician Audit-Educator (757)
Minot, ND · Remote
$193K - $242K/yr
Respond to payor audits conducted by the CMS RAC contractor, Medicare, Medicaid, as well as all ... May consider remote employee. Licenses and Certifications Required * Certification as a ...
Remote Rac Auditor information
See salary details
$64.5K - $67.5K
1% of jobs
$67.5K - $70.5K
1% of jobs
$70.5K - $73.5K
4% of jobs
$73.5K - $76.5K
4% of jobs
$76.5K - $79.5K
3% of jobs
$79.5K - $82.5K
6% of jobs
$84K is the 25th percentile. Wages below this are outliers.
$82.5K - $85.5K
10% of jobs
The median wage is $88.3K / yr.
$85.5K - $88.5K
21% of jobs
$88.5K - $91.5K
21% of jobs
$91.9K is the 75th percentile. Wages above this are outliers.
$91.5K - $94.5K
18% of jobs
$94.5K - $97.5K
10% of jobs
$64.5K
$87K
$97.5K
How much do remote rac auditor jobs pay per year?
What does a typical day look like for a Remote RAC Auditor?
A typical day for a Remote RAC Auditor involves reviewing medical records and billing data to identify discrepancies or potential overpayments related to Medicare or Medicaid claims. You'll analyze documentation, prepare audit findings and reports, and communicate with healthcare providers to clarify any issues or request additional information. Most work is performed independently, but collaboration with audit teams, compliance officers, and sometimes legal or billing departments is common. Expect your day to be a mix of data analysis, documentation review, and written or virtual communication, all while managing multiple cases to meet strict deadlines.
What are the key skills and qualifications needed to thrive in the Remote Rac Auditor position, and why are they important?
To thrive as a Remote RAC Auditor, you need a strong understanding of healthcare compliance, coding and billing practices, and knowledge of Medicare and Medicaid regulations, often supported by a degree in health information management or a related field. Proficiency with audit management software, electronic health records (EHR), and relevant certifications like Certified Coding Specialist (CCS) or Certified Professional Medical Auditor (CPMA) is typically required. Excellent analytical skills, attention to detail, and strong communication abilities are vital for collaborating with healthcare providers and delivering accurate audit results. These competencies are essential to ensure regulatory compliance, minimize financial risk, and maintain the integrity of healthcare reimbursement processes in a remote setting.
What is a Remote RAC Auditor job?
A Remote RAC (Recovery Audit Contractor) Auditor is responsible for reviewing medical claims to ensure compliance with Medicare, Medicaid, and other insurance regulations. They analyze billing data, identify improper payments, and recommend corrections to prevent fraud, waste, and abuse. This role is performed remotely, requiring strong knowledge of coding guidelines, healthcare regulations, and auditing procedures. Remote RAC Auditors typically collaborate with healthcare providers and payers to resolve discrepancies and ensure accurate reimbursements.

Job description
The Medical Review Nurse - CMS / RAC (Government Audits) primarily performs medical claims audit reviews for government clients. As a MR Nurse, you will join a team of experienced medical auditors and coders performing retrospective and prepayment audits on claims for Government Payers. You will work remotely in a fast paced and dynamic environment and be part of a multi-location team.
Please note: RAC certification is preferred for this role. The selected candidate may need to work toward RAC certification if they do not currently have it.
Key Responsibilities:
- Auditing claims for medically appropriate services provided in both inpatient and outpatient settings while applying appropriate medical review guidelines, policies and rules.
- Document all findings referencing the appropriate policies and rules.
- Generate letters articulating audit findings.
- Supporting your findings during the appeals process if requested.
- Working collaboratively with the audit team to identify and obtain approval for particular vulnerabilities and/or cases subject to potential abuse.
- Work in partnership with our clients, CMD colleagues, and other contractors on improving medical policies, provider education, and system edits.
- Keep abreast of medical practice, changes in technology, and regulatory issues that may affect our clients.
- Work with the team to minimize the number of appeals; Suggest ideas that may improve audit workflows; Assist with QA functions and training team members.
- Participate in establishing edit parameters, new issue packets and development of Medical Review Guidelines.
- Interface with and support the Medical Director and cross train in all clinical departments/areas.
- Other duties as required to meet business needs.
Knowledge, Skills and Abilities Needed:
- Experience with utilization management systems or clinical decision-making tools such as Medical Coverage Guidelines (MCG) or InterQual.
- Experience with and deep knowledge of ICD-9, ICD-10, CPT-4 or HCPCS coding.
- Knowledge of insurance programs program, particularly the coverage and payment rules.
- Ability to maintain high quality work while meeting strict deadlines.
- Excellent written and verbal communication skills.
- Ability to manage multiple tasks including desk audits and claims review.
- Must be able to independently use standard office computer technology (e.g. email telephone, copier, etc.) and have experience using a case management system/tools to review and document findings.
- Must be able to manage multiple assignments effectively, create documentation outlining findings and/or documenting suggestions, organize and prioritize workload
- Effectively work independently and as a team, in a remote setting.
Required and Preferred Qualifications:
- Active unrestricted RN license in good standing, is required.
- Must not be currently sanctioned or excluded from the Medicare program by the OIG.
- Minimum of five (5) years diversified nursing experience providing direct care in an inpatient or outpatient setting.
- One (1) or more years' experience performing medical records review.
- One (1) or more years' experience in health care claims that demonstrates expertise in, ICD-9/ICD-10 coding, HCPS/CPT coding, DRG and medical billing experience for an Insurance Company or hospital required.
- Strong preference for experience performing utilization review for an insurance company, Tricare, MAC, or organizations performing similar functions.
- RAC certification preferred.
Equal Employment Opportunity at Machinify
We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender, gender identity or expression, or veteran status. We are proud to be an equal opportunity workplace. Machinify is an employment at will employer. We participate in E-Verify as required by applicable law. In accordance with applicable state laws, we do not inquire about salary history during the recruitment process. If you require a reasonable accommodation to complete any part of the application or recruitment process, please let our recruiters know. See our Candidate Privacy Notice at: https://www.machinify.com/candidate-privacy-notice/
About Machinify
Sourced by ZipRecruiter
Industry
Software development
Company size
11 - 50 Employees
Headquarters location
Palo Alto, CA, US
Year founded
2016