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.