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Rn Rac Auditor Jobs in Wisconsin (NOW HIRING)

ThedaCare

Coding Auditor

Appleton, WI · On-site

$26.50 - $30.25/hr

... RAC, HRSA, and PERM to ensure appropriate reimbursement. Reviews internal processes to ensure ... Registered Health Information Technologist/AHIMA), or RHIA (Registered Health Information ...

Northern Lights

MDS Coordinator

Washburn, WI

$57K - $86K/yr

Current RN license in the state of employment required. * RAC-CT certification preferred or willingness to obtain within designated timeframe. ✔ Experience & Skills: * Prior experience in MDS ...

Froedtert

RN DENIALS MANAGEMENT HOURLY

Milwaukee, WI

$36.38 - $56.39/hr

... party auditors. Assists the case managers with utilization review issues, and provides ... Requires current state of Wisconsin Registered Nurse License or a Multi-state Nursing License from ...

SSM Health

Surgical Technologist

Madison, WI · On-site

Communicates information to the RN regarding patients. Job Responsibilities and Requirements: PRIMARY RESPONSIBILITIES * Practices and implements the technical components of patient care under the ...

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Rn Rac Auditor information

What is an RN RAC Auditor job?

An RN RAC (Recovery Audit Contractor) Auditor is a registered nurse who reviews medical records to ensure compliance with Medicare and Medicaid billing regulations. They analyze documentation, identify improper payments, and help healthcare providers correct billing errors. Their role is crucial in preventing fraud, ensuring accurate reimbursement, and improving healthcare compliance.

What are the key skills and qualifications needed to thrive in the Rn Rac Auditor position, and why are they important?

To thrive as an RN RAC Auditor, you need a current RN license, strong clinical background, and in-depth knowledge of Medicare and healthcare reimbursement systems. Familiarity with tools such as electronic health records (EHRs), the Resident Assessment Instrument (RAI), and coding software like ICD-10 is crucial, and certification such as RAC-CT (Resident Assessment Coordinator-Certified) is often preferred. Attention to detail, analytical thinking, and strong written and verbal communication are valuable soft skills for auditing complex medical records and collaborating with interdisciplinary teams. These competencies ensure accurate compliance, optimal reimbursement, and the maintenance of high regulatory standards within healthcare organizations.

What are some common challenges faced by RN RAC Auditors in their daily work?

RN RAC Auditors often encounter challenges such as keeping up with frequently changing Medicare regulations, ensuring meticulous accuracy in clinical documentation, and coordinating with various healthcare professionals to resolve discrepancies. The role may require balancing multiple audits simultaneously and adapting quickly to new software or compliance standards. Successful RAC Auditors rely on strong organizational skills and up-to-date industry knowledge to navigate these challenges and support their facility’s compliance and reimbursement objectives. Most auditors work closely with MDS coordinators, billing departments, and clinical teams, making clear communication and teamwork essential. Staying proactive with ongoing education and training can also help ease these hurdles and contribute to long-term career growth.

What are popular job titles related to Rn Rac Auditor jobs in Wisconsin? For Rn Rac Auditor jobs in Wisconsin, the most frequently searched job titles are:
What job categories do people searching Rn Rac Auditor jobs in Wisconsin look for? The top searched job categories for Rn Rac Auditor jobs in Wisconsin are:
Rn Rac Auditor jobs near you
Infographic showing various Rn Rac Auditor job openings in Wisconsin as of June 2026, with employment types broken down into 64% Full Time, 4% Part Time, and 32% Contract. Highlights an 93% Physical, 3% Hybrid, and 4% Remote job distribution.

Regional MDS Coordinator (RN)

Skilled Healthcare Center

Milwaukee, WI

$110K - $140K/yr

Full-time

Posted 14 days ago

Job description

The Regional MDS Coordinator (RN) provides oversight, guidance, and clinical support to multiple Skilled Nursing Facilities to ensure accurate, timely, and compliant completion of the Minimum Data Set (MDS) in accordance with CMS, state, and company standards. This role focuses on regulatory compliance, reimbursement optimization, staff education, and quality outcomes across assigned facilities.

Qualifications (Required)

  • Active Registered Nurse (RN) license in good standing (multi-state preferred if applicable)

  • Minimum 3–5 years of MDS experience in a Skilled Nursing Facility

  • Demonstrated expertise in RAI process, PDPM, and CMS regulations

  • Previous experience as an MDS Coordinator required

  • Ability to travel between assigned facilities

  • Strong analytical, organizational, and communication skills

Preferred Qualifications

  • Regional or multi-facility MDS oversight experience

  • RAC-CT or RAC-CTA certification

  • Experience with EHR systems (PointClickCare or similar)

  • Prior survey management or audit experience

Essential Duties & ResponsibilitiesRegional Oversight

  • Provide clinical and operational oversight of MDS processes across assigned SNFs

  • Ensure accurate, timely completion of all MDS assessments in compliance with CMS and state regulations

  • Monitor PDPM classification accuracy and reimbursement integrity

Compliance & Auditing

  • Conduct routine audits of MDS assessments, care plans, and supporting documentation

  • Identify risk areas related to reimbursement, quality measures, and surveys

  • Collaborate with facility leadership to implement corrective action plans

Education & Support

  • Train and mentor facility MDS Coordinators and interdisciplinary team members

  • Provide ongoing education related to RAI updates, PDPM changes, and regulatory guidance

  • Serve as a clinical resource for complex cases and assessment questions

Quality & Performance

  • Monitor quality measures, Five-Star ratings, and survey outcomes related to MDS

  • Support facilities in improving clinical documentation and care planning

  • Participate in performance improvement initiatives

Collaboration & Reporting

  • Work closely with DONs, Administrators, Therapy teams, and Corporate leadership

  • Prepare and present reports on compliance, reimbursement trends, and performance metrics

  • Assist with survey preparation and post-survey follow-up as needed

Physical & Travel Requirements

  • Ability to travel regionally (percentage as defined by employer)

  • Ability to sit, stand, and use a computer for extended periods