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Remote Quality Control Auditor Jobs in Texas (NOW HIRING)

Corvel

Clinical Review QC Auditor

Fort Worth, TX · On-site +1

$68K - $104K/yr

CERIS in Fort Worth, TX is seeking a DRG Quality Control/Clinical Auditor. The Diagnostic Related ... This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Review medical records to ...

Corvel

Clinical Review QC Auditor

Fort Worth, TX · Remote

$68K - $104K/yr

CERIS in Fort Worth, TX is seeking a DRG Quality Control/Clinical Auditor. The Diagnostic Related ... This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Review medical records to ...

CERiS

Clinical Review QC Auditor

Fort Worth, TX · Remote

$68K - $104K/yr

CERIS in Fort Worth, TX is seeking a DRG Quality Control/Clinical Auditor. The Diagnostic Related ... This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Review medical records to ...

CERiS

Clinical Review QC Auditor

Fort Worth, TX · On-site +1

$68K - $104K/yr

CERIS in Fort Worth, TX is seeking a DRG Quality Control/Clinical Auditor. The Diagnostic Related ... This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Review medical records to ...

University Health

Coding Educator/Auditor

San Antonio, TX · Remote

$24.50 - $28/hr

Provides onsite and remote quality assurance reviews/audits with appropriate compliance with ... The Coding Educator & Auditor must maintain a valid credential offered by the accrediting bodies ...

University Health

Coding Educator/Auditor

San Antonio, TX · Remote

$23.50 - $26.75/hr

Provides onsite and remote quality assurance reviews/audits with appropriate compliance with ... The Coding Educator & Auditor must maintain a valid credential offered by the accrediting bodies ...

American Cancer Society

Senior Auditor- Remote

Dallas, TX · Remote

$85K - $90K/yr

The Senior Auditor plays a critical role in delivering high-quality assurance and advisory services ... Identifyand document control weaknesses, lead entry and exit meetings with management, and deliver ...

YO AI Labs

Medical Auditor - Remote

Houston, TX · Remote

$50 - $70/hr

Medical Auditor Job Type: Contractor Location: Remote Job Overview We are seeking experienced ... Quality Assurance * Written & Verbal Communication Preferred Qualifications * 10+ years of ...

YO AI Labs

Medical Auditor - Remote

Dallas, TX · Remote

$50 - $70/hr

Medical Auditor Job Type: Contractor Location: Remote Job Overview We are seeking experienced ... Quality Assurance * Written & Verbal Communication Preferred Qualifications * 10+ years of ...

YO AI Labs

Medical Auditor - Remote

Houston, TX · Remote

$55 - $70/hr

Medical Auditor Job Type: Contractor Location: Remote Job Overview We are seeking experienced ... Support audit program management and quality improvement initiatives. Required Qualifications * 10+ ...

YO AI Labs

Medical Auditor - Remote

Austin, TX · Remote

$55 - $70/hr

Medical Auditor Job Type: Contractor Location: Remote Job Overview We are seeking experienced ... Support audit program management and quality improvement initiatives. Required Qualifications * 10+ ...

YO AI Labs

Medical Auditor - Remote

Dallas, TX · Remote

$55 - $70/hr

Medical Auditor Job Type: Contractor Location: Remote Job Overview We are seeking experienced ... Support audit program management and quality improvement initiatives. Required Qualifications * 10+ ...

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Remote Quality Control Auditor information

What does a remote quality control auditor do?

A Remote Quality Control Auditor is responsible for evaluating and ensuring the quality of products, services, or processes from a remote location. They review documents, data, or recorded transactions to verify compliance with company standards and regulatory requirements. Using digital tools, they identify discrepancies, recommend improvements, and report findings to management. This role is essential in maintaining high-quality standards while allowing flexibility to work from home or other remote locations.

What are the key skills and qualifications needed to thrive as a remote quality control auditor?

To thrive as a Remote Quality Control Auditor, you need a solid understanding of quality assurance principles, auditing procedures, and typically a relevant degree such as in business, engineering, or a related field. Familiarity with quality management systems (like ISO 9001), audit software, and data analysis tools is often essential, along with industry-recognized certifications such as Certified Quality Auditor (CQA). Critical thinking, attention to detail, and effective written and verbal communication are standout soft skills for this role. These skills ensure accurate assessments, consistent compliance, and clear reporting while working independently in a remote setting.

How do remote quality control auditors typically collaborate with on-site teams to ensure compliance and accuracy?

Remote Quality Control Auditors often work closely with on-site teams through virtual meetings, shared documentation systems, and regular progress updates. While they may not be physically present, auditors use digital tools to review process data, monitor compliance, and provide feedback. Establishing clear communication channels and building relationships with on-site personnel are key to resolving discrepancies and upholding quality standards. Regular collaboration ensures that audits are thorough and any issues are addressed promptly, maintaining the integrity of quality control processes.

What is the difference between Remote Quality Control Auditor vs Remote Quality Assurance Specialist?

AspectRemote Quality Control AuditorRemote Quality Assurance Specialist
CertificationsISO, Six Sigma, industry-specific auditsISO, Six Sigma, process improvement certifications
Work EnvironmentAuditing products/services remotely, reviewing complianceDeveloping and implementing quality processes remotely
Industry UsageManufacturing, healthcare, software testingManufacturing, healthcare, software development

Both roles focus on quality but differ in scope. Remote Quality Control Auditors primarily verify compliance through audits, while Remote Quality Assurance Specialists develop and improve quality systems. Understanding these distinctions helps job seekers target the right position based on their skills and career goals.

What cities in Texas are hiring for Remote Quality Control Auditor jobs?

Cities in Texas with the most Remote Quality Control Auditor job openings:

Clinical Review QC Auditor

Fort Worth, TX • On-site, Remote

Corvel
Insurance Services • 1 - 5K employees
Learn more about Corvelexternal

$68K - $104K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 6 days ago

CorVel rating

7.9

Company rating: 7.9 out of 10

Based on 51 frontline employees who took The Breakroom Quiz

Job description

CERIS in Fort Worth, TX is seeking a DRG Quality Control/Clinical Auditor. The Diagnostic Related Groups (DRG) Clinical Auditor will be responsible for performing DRG validation (clinical/coding) reviews of medical records and/or other documentation. This role will determine correct DRG/coding as defined by review methodologies specific to the type of review. This involves completing medical record reviews, accurately documenting findings and non-findings and providing clinical/policy/regulatory support for the determination. This role will utilize their experience with ICD-10-CM & PCS coding guidelines, the ability to understand modern pharmacology, disease management and clinical intervention procedures. The ideal DRG Clinical Auditor candidate has strong written and verbal communication skills, clinical knowledge of disease processes, and knowledge of medical necessity rules.
This is a remote position.
ESSENTIAL FUNCTIONS & RESPONSIBILITIES:
  • Review medical records to determine accuracy of billing through verification of coding and review of supporting clinical documentation
  • Check for physician's notes supporting the DRGs assigned
  • Conduct audits to ensure accurate reimbursement and identifying potential savings
  • Review previously conducted audits to ensure accurate coding and identifying potential savings
  • Review all opportunities sent to the customers for complete and correct information
  • Demonstrated knowledge of ICD-10-CM codes, PCS and DRG coding, understanding of payer rules and regulations, including Medicare and Medicaid
  • Understand and comply with all internal and external policies
  • Working knowledge of HIPAA Privacy and Security Rules
  • Assist Quality Control team and medical director with appeals, rebuttals, etc.
  • Notify leadership of any issues or concerns in a timely manner
  • Additional duties as assigned

KNOWLEDGE & SKILLS:
  • Expert knowledge of application of current Official Coding Guidelines and Coding Clinic citations
  • Solid knowledge and understanding of clinical criteria documentation requirements used to successfully substantiate code assignments
  • Proficient understanding of Medicare, CMS guidelines and ICD-10 coding guidelines
  • Effective and professional communication skills, both verbal and written
  • Ability to work independently and in a team environment
  • High attention to detail
  • Must possess critical thinking skills
  • Ability to multi-task and assist with team coverage and provide support when needed
  • Ability to build relationships both internally and externally
  • Ability to work in a fast-paced environment
  • Demonstrated proficiency in basic computer skills and typing
  • Proficiency with Microsoft Office
  • Proficient in both MS and APR DRG methodology preferred

EDUCATION & EXPERIENCE:
  • LVN or RN license in the state of employment preferred
  • Experience in the OR, ICU, or ER as an RN highly preferred
  • Required minimum of 2 year of recent DRG Quality Auditing experience in a hospital setting, or health plan. National Coding Certification required through either AHIMA (preferred) or AAPC
  • Extensive hands-on ICD-10 CM / PCS experience required

PAY RANGE:
CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time.
For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process.
Pay Range: $68,566 - $104,841
A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management
In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first.
ABOUT CERIS:
CERIS, a division of CorVel Corporation, a certified Great Place to Work® Company, offers incremental value, experience, and a sincere dedication to our valued partners. Through our clinical expertise and cost containment solutions, we are committed to accuracy and transparency in healthcare payments. We are a stable and growing company with a strong, supportive culture along with plenty of career advancement opportunities. We embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).
A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off.
CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.
#LI-Remote
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

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