Recovery Audit Contractor Services

The Vendor is required to provide recovery audit review services and conduct recovery audit contractor (RAC) activities in accordance with the requirements.
- Conduct first-level appeal reviews and facilitate second-level appeals as requested by providers.
- Performing program integrity risk assessments;
- Developing logic and algorithms to analyze large data sets and produce meaningful outcomes;
- Utilizing efficient methods to detect and refer suspected fraud, waste, abuse, and improper payments;
- Conducting government project administration, including effective management and implementation of internal controls, risk management processes, audit trail management and tracking, and information security requirements.