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Remote Rac Auditor Jobs (NOW HIRING)

Modernizing Medicine, Inc.

Medical Coding Auditor

... 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 ...

Pacs

$90K - $120K/yr

RAC-CT preferred. * Prior experience with clinical auditing and conducting internal investigations ... This role is remote, requiring less than 25% travel. Salary Range: $90,000 - $120,000 depending on ...

New

Pacs

$90K - $120K/yr

RAC-CT preferred. * Prior experience conducting audits and or conducting internal investigations ... This role is remote, requiring less than 25% travel. Pay Range: $90,000 - $120,000 annually ...

Sparc Technology Services Inc

Oracle DBA

Pittsburgh, PA · On-site +1

$60 - $65/hr

... A remote but Occasional onsite to Pittsburgh, PA Required Technical Skill Expertise in Oracle RAC ... auditing) Capacity planning and forecasting for database growth Flexible work from home options ...

TRINITY HEALTH

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 ...

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How much do remote rac auditor jobs pay per year?

As of Jun 5, 2026, the average yearly pay for remote rac auditor in the United States is $86,952.00, according to ZipRecruiter salary data. Most workers in this role earn between $84,000.00 and $92,500.00 per year, depending on experience, location, and employer.

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.

More about Remote Rac Auditor jobs
What cities are hiring for Remote Rac Auditor jobs? Cities with the most Remote Rac Auditor job openings:
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Remote Rac Auditor jobs near you
Infographic showing various Remote Rac Auditor job openings in the United States as of May 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution, with an average salary of $86,952 per year, or $41.8 per hour.
Profee Remote Auditor/Educator

Profee Remote Auditor/Educator

Presbyterian Healthcare Services

Santa Fe, NM • On-site, Remote

$54K - $83K/yr

Full-time

Medical, Dental, Vision, Life

Posted 2 days ago

Presbyterian Healthcare Services rating

7.3

Company rating: 7.3 out of 10

Based on 157 frontline employees who took The Breakroom Quiz

294th of 865 rated healthcare providers

Job description

Location Address:
Remote OfficeSanta Fe, NM 87501
Compensation Pay Range:
Minimum Offer $54,516.80Maximum Offer $83,262.40Now Hiring: Profee Remote Auditor/Educator
Summary:
Build your Career. Make a Difference. Presbyterian is hiring a skilled Profee Remote Auditor/Educator to join our team.Type of Opportunity: Full timeJob Exempt: YesJob is based: Remote Workers New MexicoWork Shift: Days (United States of America)
Responsibilities:
With minimal supervision directly supports the following responsibilities of the Coding and documentation quality assurance (CDQA) team: implementation of and compliance to enterprise-wide and department coding policies and procedures for PHS; compliance to all external regulatory agency coding rules and regulations; Demonstrates high-level of proficiency in performing and/or managing on-site internal audits or reviews to assess compliance/quality monitoring performed by PHS/PMG departments while serving as a resource on documentation, coding, billing, and coding compliance questions. Works on special coding compliance related projects, develops and presents educational programs, disseminates information to PHS/PMG departments and develops educational tools used to maintain compliance with regulations. Provides support via auditing and training the enterprise-wide corrective action plans for coding, audit, physician and clinician personnel identified as low performers; perform medical record and billing reviews of denied and appealed claims and takes appropriate action to ensure accurate payment of claims; coordinate review and tracking of appealed claims including the communication process with affected payers; research and interpret all regulatory agency regulations
Some key responsibilities include:
  • Liaison to the Manager, Information Services, Finance/Patient Financial Services, all hospitals, all PMG sites, PHP, Home Health, Albuquerque Ambulance, Compliance and all ancillary departments in addressing functional coding, auditing, compliance and training issues and problems. Interacts with all levels of management.esponsible for maintaining accurate, complete and timely documentation in either electronic or hard copy form
  • Must be able to adapt to frequently changing work priorities and schedules. Maintains and disseminates up-to-date technical knowledge of legal and regulatory information from all appropriate jurisdictions concerning the given business area. This includes but is not limited to all ICD-9, ICD-10, CPT-4, HCPCS and APC updates and changes
  • Researches coding, billing and charging compliance issues, recommends and implements corrective action plans that assure compliance with regulatory agencies where appropriate. Identifies risks, develops and follows up on action plans, identifies lost revenue opportunities and any overpayments due to errors in coding and/or documentation, and provides compliance education
  • Assists in the creation of the CDQA Annual Audit Work-plan by utilizing the OIG work plan, Medicare and Medicaid regulations, RAC and other audit agency focuses, as well as internal and external risk assessments
  • Regularly exercises independent judgment in determining the reliability of data reviewed; recommends changes in existing practices to gain or maintain compliant behavior. Keeps actively informed on the business climate of the healthcare industry
  • Responds to inquiries and requests daily regarding coding and auditing issues and problems and ad-hoc analysis for all PHS management
  • Maintains up-to-date working knowledge of all PHS coding and auditing IT applications
  • Gathers and analyzes information and provides recommendations to address and resolve business issues for a specific business group
  • Conducts training classes in areas of coding, documentation and compliance for PHS/PMG personnel. This includes preparation of training materials, educational audits and answering specific situational questions, ICD-10 education and EPIC EMR documentation education to providers and clinical staff
  • Conducts systematic focused internal audits via medical record and charge ticket review to insure correct coding, billing and charging as member of CDQA audit team
  • Analyzes and summarizes data from medical record and account audits and communicate results and findings to management and compliance. Develops new methods and processes to improve coding efficiency and effectiveness
  • Researches and investigates external and internal customer concerns regarding patient care and/or billing of patient care. Ensures that coding functions are performed in accordance with established quality and performance standards by monitoring system generated reports and quality audits
  • Working hours may vary based on projects assigned
  • Must be able to travel to all of the PHS/PMG sites (including overnight). Travel varies at certain times based on assignments

Qualifications:
  • High school diploma/GED required. Must possess at least one of the following license/certifications: RHIT, RHIA, CPC, CCS and a minimum of three (3) years experience in coding and/or auditing required. Audit experience preferred. Excellent written and verbal communication skills. . Excellent written and verbal communication skills. Detail and results oriented. Ability to work independently and make independent decisions. Medical terminology, ICD-9, CPT-4 and HCPCS knowledge required.
  • Must have a proficient knowledge of Medicare, Medicaid, and other third party payer documentation, coding, and billing regulations for service lines(s) assigned.
  • Must possess excellent organizational and planning skills, including the ability to prioritize multiple tasks and perform them both accurately and simultaneously.
  • Must possess computer skills, especially with Microsoft Word, PowerPoint, and Excel applications. Must be able to use the internet and other resource applications for research purposes and to provide documentation that supports regulations quoted in audits.
  • Must possess strong written and verbal communication skills in order to communicate in clear, concise terms to management at all levels, including the ability to articulate complex regulatory information in laymans terms.
  • Must possess a personal presence of a highly qualified professional that is characterized by a sense of honesty, integrity, and the ability to inspire and motivate others.

All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.
Wellness
Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.
Why work at Presbyterian?
As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.
About Presbyterian Healthcare Services
Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.
Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.
AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.
We're Determined to Support New Mexico's Well-Being | Presbyterian Healthcare Services

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About Presbyterian Healthcare Services

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Presbyterian Healthcare Services exists to improve the health of patients, members and the communities we serve. We are a locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1,600 providers and nearly 4,700 nurses.

Industry

Hospitals

Company size

10,000+ Employees

Headquarters location

Albuquerque, NM, US

Year founded

1908

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