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Specialist Rac Audit Jobs (NOW HIRING)

Trinity Health

Physician Audit-Educator (757)

Minot, ND · On-site

$193K - $242K/yr

Respond to payor audits conducted by the CMS RAC contractor, Medicare, Medicaid, as well as all ... Specialist Physician (CCS-P) through American Health Information Management Association.

Trinity Health

Physician Audit-Educator (757)

Minot, ND · On-site

$172K - $216K/yr

Respond to payor audits conducted by the CMS RAC contractor, Medicare, Medicaid, as well as all ... Specialist Physician (CCS-P) through American Health Information Management Association.

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 ... Specialist Physician (CCS-P) through American Health Information Management Association.

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Specialist Rac Audit information

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$36K

$76.5K

$116.5K

How much do specialist rac audit jobs pay per year?

As of Sep 8, 2026, the average yearly pay for specialist rac audit in the United States is $76,517.00, according to ZipRecruiter salary data. Most workers in this role earn between $37,500.00 and $116,500.00 per year, depending on experience, location, and employer.

What is a Specialist RAC Audit?

A Specialist RAC Audit is a professional who focuses on reviewing and analyzing medical records to ensure compliance with Medicare and Medicaid guidelines, specifically as part of the Recovery Audit Contractor (RAC) program. Their primary role is to identify and correct improper payments made to healthcare providers, such as overpayments or underpayments. They work with hospitals, clinics, and other healthcare organizations to prepare for RAC audits, respond to audit requests, and implement corrective actions based on audit findings. These specialists must have strong knowledge of healthcare coding, billing regulations, and federal compliance standards.

What are the key skills and qualifications needed to thrive as a Specialist RAC Audit, and why are they important?

A Specialist RAC Audit requires in-depth knowledge of healthcare compliance, medical billing, coding standards (such as ICD-10 and CPT), and typically a background in health information management or nursing. Familiarity with audit software, electronic medical records (EMR) systems, and certifications like RHIA, RHIT, or CPC are often expected. Strong analytical thinking, attention to detail, and effective communication skills help professionals accurately review claims and collaborate with providers. These competencies are crucial to ensure regulatory compliance, minimize financial risk, and support accurate reimbursement in healthcare organizations.

What are some common challenges faced by a Specialist RAC Audit, and how can they be managed effectively?

Specialist RAC Auditors often encounter challenges such as interpreting complex medical records, staying up-to-date with changing Medicare regulations, and managing tight deadlines for audit responses. Effective management involves continuous professional education, fostering strong communication with clinical staff, and utilizing audit management software to organize documentation and track appeals. Building collaborative relationships with billing, compliance, and coding teams also helps ensure a thorough and accurate audit process.

What is the difference between Specialist Rac Audit vs RAC Auditor?

AspectSpecialist Rac AuditRAC Auditor
CredentialsCertifications in RAC auditing, compliance, or related fieldsCertifications in RAC auditing, compliance, or related fields
Work EnvironmentHealthcare facilities, insurance companies, or government agenciesHealthcare providers, insurance companies, or government agencies
Industry UsageCommonly used in healthcare and insurance sectors for RAC auditsUsed interchangeably in healthcare and insurance sectors for RAC-related reviews

Both roles focus on RAC (Recovery Audit Contractor) audits, requiring similar certifications and working in comparable environments. The main difference lies in job titles used by employers, but their responsibilities and industry usage are largely aligned.

What are popular job titles related to Specialist Rac Audit jobs?

For Specialist Rac Audit jobs, the most frequently searched job titles are:

Infographic showing various Specialist Rac Audit job openings in the United States as of September 2026, with employment types broken down into 1% As Needed, 84% Full Time, 13% Part Time, and 2% Contract. Highlights an 82% Physical, 2% Hybrid, and 16% Remote job distribution, with an average salary of $76,517 per year, or $36.8 per hour.

PAYER ANALYTICS SPECIALIST

Laurel, MS • On-site

South Central Regional Medical Center
Health Care and Social Assistance • 1 - 5K employees
Learn more about South Central Regional Medical Centerexternal

Full-time

Re-posted 17 days ago

South Central Regional Medical Center rating

5.3

Company rating: 5.3 out of 10

Based on 21 frontline employees who took The Breakroom Quiz

963rd of 1,066 rated hospitals

Job description

Job Title:

Payer Analytics Specialist

Department:

Patient Accounts / Revenue Cycle

Full Time/PRN:

Full Time, Monday-Friday 

Job Summary

The Payer Analytics Specialist reports to the Patient Accounts Director and provides reporting and analysis related to payer reimbursement trends, denials, and revenue cycle performance. This role supports data-driven decision-making through detailed payer analysis, trend identification, and collaboration with revenue cycle stakeholders to improve reimbursement outcomes.

Essential Duties & Responsibilities

Research and analyze insurance claim denials, ADR requests, recoupments, and underpayments; Utilize EMR and clearinghouse analytics tools; Identify trends and provide monthly and quarterly reports; Collaborate with admissions, billing, coding, administration, and provider liaisons; Submit and track appeals; Respond to payer and RAC audit requests; Maintain payer reference materials; Assist with special projects and complex billing issues; Maintain current knowledge of government and commercial payors; Track denial trends, perform root cause analysis, and recommend process improvements.

Education & Experience

High school diploma or GED required; Associate’s or Bachelor’s degree preferred; One year experience in hospital or professional billing, medical coding, or healthcare registration preferred; Ability to type at least 30 WPM; Demonstrated verbal and written communication skills.

Minimum Qualifications

Knowledge of insurance billing procedures and medical terminology; Strong attention to detail; Ability to manage multiple tasks; Proficiency in Microsoft Office; Experience with billing software preferred; Strong organizational and time-management skills; Ability to maintain confidentiality and comply with HIPAA; Knowledge of ICD-10, CPT/HCPCS, medical necessity guidelines; Strong analytical and problem-solving skills; Ability to interpret payer policies and contractual language.


All candidates must be able to perform the essential functions of this position. The American with Disabilities Act (ADA) requires that reasonable accommodations be made for qualified individuals to help perform the essential functions of the position.   

South Central Regional Medical Center is an equal opportunity employer and does not discriminate based on race, color, religion, sex, gender, national origin, age, disability, or genetic information.   

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