How to Become a Recovery Audit Contractor (RAC) Coordinator

Find out how to become a recovery audit contractor (RAC) coordinator. Research the education requirements and learn about the experience you need to advance your career as an RAC coordinator.

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Do I Want to Be a Recovery Audit Contractor Coordinator?

A recovery audit contractor (RAC) is a company that's tasked with preventing the waste of Medicare funds by identifying both underpayments and overpayments submitted to the Centers for Medicare and Medicaid Services (CMS) by healthcare providers. An RAC coordinator typically works for a large healthcare organization, such as a hospital, and is responsible for investigating, collecting and turning over to RACs any medical billing information that indicates improper payments. Duties also include coordinating any appeals or other types of follow-up action items. Many work hours might be spent in an office at a desk.

Job Requirements

Generally, an associate's or bachelor's degree, as well as a registered nursing license are required. Sometimes an advanced degree is preferred. The following table presents requirements gathered from open RAC coordinator job postings in May 2013:

Common Requirements
Degree Level Varies, can range from associate's degree to master's degree, depending on employer
Degree Fields Healthcare administration, health information management, nursing or a related field
Licensure RN license often required
Experience Minimum of one year of related experience, though employers frequently require more
Key Skills Training in Medicare billing and CMS processes can be required by employers
Computer Skills Microsoft Office applications

Step 1: Earn an Undergraduate Degree

A bachelor's degree is usually preferred and often required for aspiring RAC coordinators. Common majors are nursing, healthcare, business, finance or a related discipline. However, some employers only require an associate's degree, though those positions might also require more work experience.

Step 2: Obtain a Registered Nurse (RN) License

Many employers require RAC coordinators to be licensed RNs in their state. To become an RN, an individual must earn an undergraduate degree in nursing and passing the National Council Licensure Examination for Registered Nurses (NCLEX-RN).

Success Tip:

Consider earning a graduate degree. Some employers prefer an RAC coordinator with a master's degree. The field of study is not often specified, but options could include those required for a bachelor's degree, which includes areas of business, finance and nursing.

Step 3: Gain Work Experience

Work experience requirements can vary greatly. Often at least one year of experience is required, but often three or more are preferred. Employers frequently seek candidates with critical care experience and knowledge of clinical procedures, appeals processes and medical records.

Success Tips:

Develop computer skills. A majority of the job will be performed on the computer, so it's vital that RAC coordinators have a working knowledge of all Microsoft Office programs, particularly Word and Excel. There are also a number of industry-specific computer applications that aspiring RAC coordinators must master.

Become professionally certified. Some employers seek RACs with certifications related to their job duties. A variety of credentials are available, such as case management or medical review certification. The American Health Information Management Association offers the Registered Health Information Administrator (RHIA) and Registered Health Information Technician (RHIT) credentials. To become eligible, applicants seeking the RHIA certification should have a bachelor's degree in health information management, while RHIT candidates need an associate's degree in the field.

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