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 ...
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 ...
Los Angeles, CA · On-site +1
$123K - $180K/yr
Los Angeles, CA Job Type: Full-Time Remote Employment: Flexible/Hybrid Job Number: R9657A ... Ensure database security and compliance through access control, auditing, encryption, vulnerability ...
Los Angeles, CA · On-site +1
$123K - $180K/yr
Los Angeles, CA Job Type: Full-Time Remote Employment: Flexible/Hybrid Job Number: R9657A ... Ensure database security and compliance through access control, auditing, encryption, vulnerability ...
$63.7K - $66.6K
1% of jobs
$66.6K - $69.6K
1% of jobs
$69.6K - $72.5K
4% of jobs
$72.5K - $75.5K
4% of jobs
$75.5K - $78.5K
3% of jobs
$78.5K - $81.4K
6% of jobs
$82.9K is the 25th percentile. Wages below this are outliers.
$81.4K - $84.4K
10% of jobs
The median wage is $87.2K / yr.
$84.4K - $87.3K
21% of jobs
$87.3K - $90.3K
21% of jobs
$90.7K is the 75th percentile. Wages above this are outliers.
$90.3K - $93.3K
18% of jobs
$93.3K - $96.2K
10% of jobs
$63.7K
$85.8K
$96.2K
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.
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.
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.
Full-time
Posted 3 days ago
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), Targeted Provider Education (TPE), Comprehensive Error Rate Testing (CERT), Office of Inspector General (OIG), Quality Improvement Organizations (QIO) and other Medicaid, Medi-Cal 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.
1-3 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), Targeted Provider Education (TPE), Comprehensive Error Rate Testing (CERT), Office of Inspector General (OIG), and other Medicaid, Medi-Cal 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
1-3 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:
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), Targeted Provider Education (TPE), Comprehensive Error Rate Testing (CERT), Office of Inspector General (OIG), and other Medicaid, Medi-Cal and other regulatory audits
5 years of experience in Medicare billing, follow up, appeals
Knowledge of utilization management process, coding, medical necessity criteria
Education:
Required Education:
High school diploma or equivalent experience.
Required Certifications & Licensure:
High school diploma or equivalent experience
Languages:
English
Schedule Notes:
Is this position Remote No Work Location Address: 2995 Red Hill Ave Costa Mesa CA LOA Coverage
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We understand that attracting, qualifying, placing, and retaining the best candidates for our clients requires exceptional talent. That’s why our highly skilled and dedicated recruitment team works tirelessly to develop lifelong associations with all candidates and clients. We prioritize helping our employees achieve their career goals while providing effective staffing solutions to our clients and candidates. At Apidel, we believe in simple yet established core values that are ingrained within each member of our team. These values are time and again illustrated in our approach to employees, candidates, and clients. Our unwavering belief that our core values of integrity, client satisfaction, innovation, and intellect distinguish us from our competitors is what drives us forward. We remain focused on improving and sustaining a measurable client satisfaction program that has created an organizational culture where our associates provide world-class service every day.
Recruiting and staffing services
501 - 1,000 Employees
Plainfield, IL, US
2012