Government Audit Recovery Specialist

Government Recovery Specialist – SummaryResponsible for supporting CMS Recovery Audit Contractor (RAC) and other government audit programs by managing documentation, billing compliance, data entry, mail processing, audit preparation, and communication with regulatory agencies (including MAC, TPE, CERT, OIG, QIO, Medicaid/Medi-Cal).Key Requirements:3+ years Medicare billing experience in an acute care setting1–3 years experience in healthcare regulatory audits and appealsStrong understanding of CMS billing, reimbursement, and compliance rulesExperience with complex healthcare projectsProficiency in MS Office (Word, Excel, PowerPoint, Outlook)Knowledge of privacy/security regulations and release of informationPreferred:5+ years acute care experience and Medicare billingExtensive experience with RAC/MAC/CERT/OIG audits and appealsUnderstanding of utilization management, coding, and medical necessity criteriaEducation:High school diploma or equivalent experience