How to become a rac auditor

how to become a rac auditor

What are Recovery Audit Contractors?

A recovery audit contractor (RAC) is responsible for identifying and recovering improper Medicare payments made to health care providers under patients' fee-for-service Medicare plans. Medicare is a large-scale program with a lot of potential for wasted and abused funds, and RACs work to prevent these discrepancies within the Medicare program.

Recovery Audit Contractor Job Description

Recovery audit contractors work hard to sift through improper Medicare payments, including both situations with overpayments and underpayments. Recovery audit contractors review three years' worth of health care provider claims made for hospital inpatient, outpatient, nursing, physician, ambulance, and lab services using proprietary software programs designed to identify errors such as duplicate pays and mistakes in the coding. A recovery audit contractor may likely also be responsible for conducting reviews of pertinent medical records.

How to Become a Recovery Audit Contractor

Both a college degree and related experience are very important when looking for a job as a recovery audit contractor. Many potential contractors major in health care, business or finance. With an associate's or bachelor's degree in health care information or administration, many potential employers would consider you as a RAC. Experience in an area such as medical insurance auditing also gets your foot in the door to becoming a RAC, as does coding specialist certification and knowledge of using and maintaining computers. In general, a combination of experience and college education is required along with impeccable ethics to obtain a recovery audit contractor career.

Salary Expectations for a RAC

A recovery audit contractor receives their payment on

a contingency basis, earning a certain percentage of the overpayments and underpayments they successfully identify and retrieve for health care providers. The median hourly wage estimate for a recovery audit contractor is $29.66, while the median annual wage is $61,690. A recovery audit contractor may earn a higher or lower wage depending on region and experience. The states with the highest levels of recovery audit contractor employment are California with an annual mean wage of $74,360, New York with $85,230, Texas with $68,090, Pennsylvania with $68,610 and Florida with $63,600.

Job Outlook for a Recovery Audit Contractor

Although the American job market is struggling, recovery audit contracting is a relatively new career, thus there are more potential job openings for the right person. The occupation has only been around in the last decade, leaving little time for the job market to become saturated with those searching for a job as a RAC and holding the right degree. Only those with impeccable ethic and communication skills are considered; a RAC has access to many sensitive and confidential materials, making the ability to maintain high standards of the highest priority.

Abuse and waste of Medicare funds is a serious problem that can have negative effects on everyone. This is where the dedicated and skilled recovery audit contractors come in. Anyone with a degree in finance, business or health administration along with good ethics and a bit of experience can become a RAC. This career has a strong outlook and provides a valuable service to the American taxpayers by eliminating the waste of government dollars.


Category: Taxes

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