Job Title: Clinical Nurse Auditor - Payment Integrity Job Summary We are seeking an experienced ... This position requires a Registered Nurse (RN) with coding certifications such as CPC (Certified ...
Quick apply
Job Title: Clinical Nurse Auditor - Payment Integrity Job Summary We are seeking an experienced ... This position requires a Registered Nurse (RN) with coding certifications such as CPC (Certified ...
Quick apply
Job Title: Clinical Nurse Auditor - Payment Integrity Job Summary We are seeking an experienced ... This position requires a Registered Nurse (RN) with coding certifications such as CPC (Certified ...
Job Title: Clinical Nurse Auditor - Payment Integrity Job Summary We are seeking an experienced ... This position requires a Registered Nurse (RN) with coding certifications such as CPC (Certified ...
Job Title: Clinical Nurse Auditor - Payment Integrity Job Summary We are seeking an experienced ... This position requires a Registered Nurse (RN) with coding certifications such as CPC (Certified ...
Job Title: Clinical Nurse Auditor - Payment Integrity Job Summary We are seeking an experienced ... This position requires a Registered Nurse (RN) with coding certifications such as CPC (Certified ...
Job Title: Clinical Nurse Auditor - Payment Integrity Job Summary We are seeking an experienced ... This position requires a Registered Nurse (RN) with coding certifications such as CPC (Certified ...
Saint Joseph, MO ยท On-site +1
The Denials Nurse Auditor is responsible for completing, appealing, tracking, and reporting ... Registered Nurse (RN) - State Licensure/Or Compact State Licensure - Registered Nurse license by ...
Saint Joseph, MO ยท On-site +1
The Denials Nurse Auditor is responsible for completing, appealing, tracking, and reporting ... Registered Nurse (RN) - State Licensure/Or Compact State Licensure - Registered Nurse license by ...
Silver Spring, MD ยท Remote
$68K - $75K/yr
My Account Job Openings >> Remote Registered Nurse (RN) - Plan of Care & OASIS Specialist Remote Registered Nurse (RN) - Plan of Care & OASIS Specialist Summary Title: Remote Registered Nurse (RN) - ...
Silver Spring, MD ยท Remote
$68K - $75K/yr
My Account Job Openings >> Remote Registered Nurse (RN) - Plan of Care & OASIS Specialist Remote Registered Nurse (RN) - Plan of Care & OASIS Specialist Summary Title: Remote Registered Nurse (RN) - ...
Redding, CA ยท On-site +1
$34 - $35/hr
Are you a Registered Nurse (RN) with Critical Care and ER experiencelooking to move away from the ... REMOTE* Clinical Quality Assurance Nurse Auditor to join the team! Schedule:: Monday-Friday 8am-5pm ...
Redding, CA ยท On-site +1
$34 - $35/hr
Are you a Registered Nurse (RN) with Critical Care and ER experiencelooking to move away from the ... REMOTE* Clinical Quality Assurance Nurse Auditor to join the team! Schedule:: Monday-Friday 8am-5pm ...
Omaha, NE ยท Remote
$27.59 - $56.63/hr
... remote work flexibility, but the selected candidate must reside in Nebraska. Opportunity for a Registered Nurse who has a US license in good standing to join our Medicaid Team as a Clinical Auditor.
Omaha, NE ยท Remote
$27.59 - $56.63/hr
... remote work flexibility, but the selected candidate must reside in Nebraska. Opportunity for a Registered Nurse who has a US license in good standing to join our Medicaid Team as a Clinical Auditor.
... remote work flexibility, but the selected candidate must reside in Nebraska. Opportunity for a Registered Nurse who has a US license in good standing to join our Medicaid Team as a Clinical Auditor.
... remote work flexibility, but the selected candidate must reside in Nebraska. Opportunity for a Registered Nurse who has a US license in good standing to join our Medicaid Team as a Clinical Auditor.
Passaic, NJ ยท On-site +1
$35 - $45/hr
Remote Registered Nurse (RN) - Principal Care Management (PCM) Join Elaya Health - Improving Specialty Care in Nursing Homes ๐ Remote Position ๐ Full Time / Part Time Available ๐ป Work From ...
Passaic, NJ ยท On-site +1
$35 - $45/hr
Remote Registered Nurse (RN) - Principal Care Management (PCM) Join Elaya Health - Improving Specialty Care in Nursing Homes ๐ Remote Position ๐ Full Time / Part Time Available ๐ป Work From ...
New York, NY ยท Remote
$75K - $100K/yr
Remote Registered Nurse (RN) - Principal Care Management (PCM)Join Elaya Health - Improving Specialty Care in Nursing Homes ๐ Remote Position ๐ Full Time / Part Time Available ๐ป Work From ...
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New York, NY ยท Remote
$75K - $100K/yr
Remote Registered Nurse (RN) - Principal Care Management (PCM)Join Elaya Health - Improving Specialty Care in Nursing Homes ๐ Remote Position ๐ Full Time / Part Time Available ๐ป Work From ...
Toledo, OH ยท Remote
$35.75 - $46.50/hr
Description REMOTE RN MDS CONSULTANT-Full Time Engage Consulting is seeking an experienced Registered Nurse (RN) with strong MDS, Case Mix, and Quality Measure experience to join our team. This is a ...
New
Toledo, OH ยท Remote
$35.75 - $46.50/hr
Description REMOTE RN MDS CONSULTANT-Full Time Engage Consulting is seeking an experienced Registered Nurse (RN) with strong MDS, Case Mix, and Quality Measure experience to join our team. This is a ...
New
Toledo, OH ยท On-site +1
Job Type Full-time Description REMOTE RN MDS CONSULTANT-Full Time Engage Consulting is seeking an experienced Registered Nurse (RN) with strong MDS, Case Mix, and Quality Measure experience to join ...
Toledo, OH ยท On-site +1
Job Type Full-time Description REMOTE RN MDS CONSULTANT-Full Time Engage Consulting is seeking an experienced Registered Nurse (RN) with strong MDS, Case Mix, and Quality Measure experience to join ...
Lincoln, NE ยท Remote
$27.59 - $56.63/hr
... remote work flexibility, but the selected candidate must reside in Nebraska. Opportunity for a Registered Nurse who has a US license in good standing to join our Medicaid Team as a Clinical Auditor.
Lincoln, NE ยท Remote
$27.59 - $56.63/hr
... remote work flexibility, but the selected candidate must reside in Nebraska. Opportunity for a Registered Nurse who has a US license in good standing to join our Medicaid Team as a Clinical Auditor.
Long Beach, CA ยท Remote
$27.59 - $56.63/hr
... remote work flexibility, but the selected candidate must reside in Nebraska. Opportunity for a Registered Nurse who has a US license in good standing to join our Medicaid Team as a Clinical Auditor.
Long Beach, CA ยท Remote
$27.59 - $56.63/hr
... remote work flexibility, but the selected candidate must reside in Nebraska. Opportunity for a Registered Nurse who has a US license in good standing to join our Medicaid Team as a Clinical Auditor.
Long Beach, CA ยท On-site +1
$29.05 - $56.64/hr
... Registered Nurse (RN). License must be active and restricted in state of practice. โข Strong ... Preferred Qualifications Prior experience in clinical review/auditing of care management.
Long Beach, CA ยท On-site +1
$29.05 - $56.64/hr
... Registered Nurse (RN). License must be active and restricted in state of practice. โข Strong ... Preferred Qualifications Prior experience in clinical review/auditing of care management.
Lincoln, NE ยท Remote
$27.59 - $56.63/hr
... remote work flexibility, but the selected candidate must reside in Nebraska. Opportunity for a Registered Nurse who has a US license in good standing to join our Medicaid Team as a Clinical Auditor.
Lincoln, NE ยท Remote
$27.59 - $56.63/hr
... remote work flexibility, but the selected candidate must reside in Nebraska. Opportunity for a Registered Nurse who has a US license in good standing to join our Medicaid Team as a Clinical Auditor.
Long Beach, CA ยท On-site +1
$27.59 - $56.63/hr
... remote work flexibility, but the selected candidate must reside in Nebraska. Opportunity for a Registered Nurse who has a US license in good standing to join our Medicaid Team as a Clinical Auditor.
Long Beach, CA ยท On-site +1
$27.59 - $56.63/hr
... remote work flexibility, but the selected candidate must reside in Nebraska. Opportunity for a Registered Nurse who has a US license in good standing to join our Medicaid Team as a Clinical Auditor.
Kansas City, MO ยท On-site +1
As a Remote RN Clinical Supervisor, you'll play a critical role in providing remote clinical oversight and supervisory support to hospice branch operations. This position focuses on clinical ...
Kansas City, MO ยท On-site +1
As a Remote RN Clinical Supervisor, you'll play a critical role in providing remote clinical oversight and supervisory support to hospice branch operations. This position focuses on clinical ...
Chicago, IL ยท On-site +1
Rising Medical Solutions is looking for a Nurse Auditor who wants to make their mark in the world ... Requirements * RN (or LPN) with active professional license or equivalent within states of ...
Chicago, IL ยท On-site +1
Rising Medical Solutions is looking for a Nurse Auditor who wants to make their mark in the world ... Requirements * RN (or LPN) with active professional license or equivalent within states of ...
Rising Medical Solutions is looking for a Nurse Auditor who wants to make their mark in the world ... Requirements * RN (or LPN) with active professional license or equivalent within states of ...
Quick apply
Rising Medical Solutions is looking for a Nurse Auditor who wants to make their mark in the world ... Requirements * RN (or LPN) with active professional license or equivalent within states of ...
$19.71 - $22.16
6% of jobs
$22.16 - $24.61
6% of jobs
$24.61 - $27.05
3% of jobs
$28.63 is the 25th percentile. Wages below this are outliers.
$27.05 - $29.50
15% of jobs
$29.50 - $31.95
17% of jobs
The median wage is $32.28 / hr.
$31.95 - $34.40
23% of jobs
$35.27 is the 75th percentile. Wages above this are outliers.
$34.40 - $36.84
15% of jobs
$36.84 - $39.29
8% of jobs
$39.29 - $41.74
0% of jobs
$41.74 - $44.19
0% of jobs
$44.19 - $46.63
7% of jobs
$19
$32
$46
| Aspect | Remote Rn Auditor | Remote Rn Reviewer |
|---|---|---|
| Certifications | RN license, auditing certifications (e.g., CHAP, RAC) | RN license, clinical review certifications |
| Work Environment | Healthcare organizations, insurance companies, auditing firms | Healthcare providers, insurance companies, utilization review |
| Primary Responsibilities | Auditing medical records for compliance, coding accuracy, and billing | Reviewing medical records for appropriateness and medical necessity |
Remote Rn Auditors focus on compliance and coding accuracy through audits, while Remote Rn Reviewers primarily assess medical necessity and appropriateness of care. Both roles require RN licensure and related certifications, often working within healthcare or insurance settings. The key difference lies in their core functions: auditing versus clinical review, though both contribute to quality and compliance in healthcare reimbursement.
As a remote RN auditor, your job is to review claims and audit financial statements to ensure validity and accuracy. In this role, you may examine documentation from the patient or clinic, evaluate the effectiveness of care, or ensure that claims comply with government regulations. RN auditors often provide advice for cutting costs and contact both healthcare providers and clients to negotiate specific claims or resolve billing issues. Remote RN auditors often work with daily or weekly batches of work as assigned, but in rare cases, you may be asked to prioritize auditing certain material when time is of the essence.
Alexandria, VA โข Remote
Full-time
Posted 9 days ago
Job Title: Clinical Nurse Auditor โ Payment Integrity
Job Summary
We are seeking an experienced Clinical Nurse Auditor to join our Payment Integrity team. In this role, you will leverage your clinical expertise, medical coding proficiency, and auditing skills to identify, monitor, and analyze unusual utilization patterns and potential fraud by healthcare providers. You will conduct prepayment claims reviews, post-payment audits, and comprehensive provider record reviews to ensure accurate billing, compliance with payer regulations, and integrity in reimbursement practices. This position requires a Registered Nurse (RN) with coding certifications such as CPC (Certified Professional Coder), CIC (Certified Inpatient Coder), CDI (Clinical Documentation Improvement), or a similar credential, through AAPC or AHIMA. Knowledge of commercial insurance plans, Medicare, and Medicaid programs is essential.
How You Will Make an Impact
Requirements
Qualifications
Preferred Traits
Sourced by ZipRecruiter
Business management consulting
51 - 200 Employees
Alexandria, VA, US
2009