MEDICAID RECOVERY AUDIT CONTRACTOR (RAC)

• Perform clinical and coding audits of Medicaid claims using AI/ML and data‑mining tools. • Recover over‑payments, identify under‑payments, and coordinate recoupments with MCOs. • Maintain a secure, HIPAA‑compliant data warehouse and provider portal (Section 508/WCAG compliance). • Provide provider education, toll‑free support, and timely inquiry responses (≤5 business days). • Deliver implementation, annual, quality‑assurance, and turnover plans; meet SLA metrics (≤10 % overturn rate). • Submit monthly invoices; compensation is contingency‑based on dollars actually recovered.