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Nurse Auditor Jobs (NOW HIRING)

Adventist Health

Chart Auditor (Portland)

Portland, OR · On-site

Chart Auditor Adventist Health Portland is looking for a Chart Auditor for full-time, day shift. We ... Associate's degree in Nursing or related clinical field: Required * Bachelor's Degree in Nursing ...

Ochsner Health

RN Nurse Auditor- Remote

Meridian, MS · On-site

Certifications Required - Current registered nurse (RN) license in state of practice. Preferred ... Performs defensive and charge capture auditing functions. * Handles all aspects of the Chart Audit ...

US Tech Solutions

HEDIS RN - Quality Auditor

Newark, NJ · On-site

$40 - $42/hr

The HEDIS Nurse Auditor is responsible for conducting quality audits related to state audits, HEDIS measures, and quality-related complaints and referrals. * This role also supports data analysis and ...

MMC Group

DRG Auditor

San Antonio, TX · Remote

Follow proper procedure for referral to Clinical Nurse Auditor or Physician Advisor. * Utilize proper reference material, standards, and guidelines for coding. * Provide input to the Edit Development ...

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Nurse Auditor information

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$32

$46

How much do nurse auditor jobs pay per hour?

As of Aug 14, 2026, the average hourly pay for nurse auditor in the United States is $32.99, according to ZipRecruiter salary data. Most workers in this role earn between $28.85 and $36.06 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a nurse auditor, and why are they important?

To thrive as a Nurse Auditor, you need a solid background in nursing, strong analytical skills, and in-depth knowledge of healthcare regulations, typically supported by RN licensure and experience in clinical or case review settings. Familiarity with auditing software, electronic health record (EHR) systems, and coding standards such as ICD-10 and CPT is essential. Attention to detail, critical thinking, and effective communication are key soft skills that help in identifying discrepancies and collaborating with healthcare teams. These skills ensure accurate audits, regulatory compliance, and the financial integrity of healthcare organizations.

What are some common challenges nurse auditors face when reviewing medical records, and how can they effectively address them?

Nurse Auditors often encounter challenges such as incomplete documentation, discrepancies between physician notes and billing codes, and navigating complex healthcare regulations. To address these, they must maintain strong attention to detail, keep up-to-date with coding standards, and communicate effectively with clinical and administrative staff to clarify ambiguities. Building collaborative relationships with the healthcare team and participating in ongoing education can also help Nurse Auditors stay current and improve the accuracy and efficiency of their audits.

What is the difference between Nurse Auditor vs Medical Coder?

AspectNurse AuditorMedical Coder
Required CredentialsRN license, certification in healthcare auditing (e.g., CHAA)Certification in coding (e.g., CPC, CCS)
Work EnvironmentHospitals, insurance companies, healthcare facilitiesMedical offices, hospitals, billing companies
Employer & Industry UsageHealthcare auditing and complianceMedical billing and coding

Both Nurse Auditors and Medical Coders work in healthcare settings, but Nurse Auditors focus on reviewing billing and compliance from an auditing perspective, often requiring RN licensure and auditing certifications. Medical Coders specialize in translating medical procedures into codes for billing, primarily needing coding certifications. While their roles overlap in healthcare documentation, their core responsibilities and certifications differ.

What is a nurse auditor?

Nurse Auditors are registered nurses who specialize in reviewing medical records, billing data, and healthcare services to ensure accuracy, compliance, and proper reimbursement. They analyze healthcare documentation to verify that services provided are medically necessary and billed correctly according to regulations and standards. Nurse Auditors often work for hospitals, insurance companies, or government agencies and play a crucial role in preventing fraud, reducing costs, and improving the quality of patient care.
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Nurse Auditor jobs near you
Infographic showing various Nurse Auditor job openings in the United States as of August 2026, with employment types broken down into 68% Full Time, 13% Part Time, 6% Temporary, and 13% Contract. Highlights an 100% In-person job distribution, with an average salary of $68,617 per year, or $33 per hour.

Nurse Auditor - Medical Bill Review (Remote)

Rising Medical Solutions

Chicago, IL • On-site, Remote

Full-time

Medical, Retirement, PTO

Re-posted 15 days ago

Job description

Have you ever looked a medical bill and immediately noticed something was wrong? Were you itching to use your expertise to fix it? We've been there, too. In fact, that's how our business was born - and continues to thrive. Rising Medical Solutions is looking for a Nurse Auditor who wants to make their mark in the world of medical cost containment.
Join our team and maximize client savings by reviewing medical bills from a nurse perspective, including appropriate billing, coding and treatment, fee schedule compliance, over-utilization, and erroneous charges. We pride ourselves on outstanding customer service and work hard to keep our impeccable reputation in the industry.
In this role, you'll be a part of our mission by giving clients the information they need to determine case value based on evaluation of medical records and medical billing statements, and will:
  • Audit medical and billing records to determine if services provided are reasonable, appropriate and necessary.
  • Clinically identify and evaluate any charges not related to the occurrence.
  • Verify that charges are in accordance with the services ordered and authorized.
  • Initiate appropriate contacts with clients and medical providers as appropriate and necessary.
  • Negotiate bills and conduct re-evaluation reviews as required

All while maintaining a human touch, demonstrating sensitivity to culturally-diverse people and situations.
Requirements
  • RN (or LPN) with active professional license or equivalent within states of operation
  • CPC and/or CPC-H certification(s) strongly desired
  • Specialized training in hospital coding, ortho, neuro, rehab, or ER procedures
  • 3-5 years of clinical experience in acute care, surgery and/or orthopedic
  • Workers' Compensation medical bill review experience a major plus
  • Understanding of CPT and ICD-10 codes and Medicare guidelines
  • Ability to apply knowledge to state fee schedules
  • A customer service orientation, including strong communication skills
  • Experience in any deposition or litigation cases a plus

Benefits
  • Competitive benefits package, including health insurance, 401(k) with company match, paid time off, paid holidays, and more.
  • Flexible hybrid schedule with in-office days reserved for training and collaborative meetings
  • Employment within a firm committed to core values, staff development, emerging technology, private ownership, and controlled growth/reinvestment in the future - we frequently promote from within!
  • Opportunity to make a difference in reducing health care costs and increasing the value of health care to individuals and their employers.
  • A relaxed, yet upbeat work environment
  • And for those in the office: casual dress code with unlimited coffee!

Apply