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Remote Rn Auditor Jobs in Missouri (NOW HIRING)

Zelis

Inpatient DRG Sr. Reviewer

Saint Louis, MO · On-site +1

$95K - $120K/yr

Registered Nurse licensure preferred * Inpatient Coding Certification required (i.e., CCS, CIC ... We foster a hybrid and remote friendly culture, and all our employee's work locations are based on ...

ComForCare

Assistant & Research Intern

MO · On-site +1

Is an experienced clinician or student, a registered nurse, or holds an associates degree or the ... This is a remote position. Live your best life possible while helping others live theirs Our ...

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All JobsRemote Rn Auditor JobsRemote Rn Auditor Jobs in Missouri

Remote Rn Auditor information

See Missouri salary details

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$43

How much do remote rn auditor jobs pay per hour?

As of Jun 28, 2026, the average hourly pay for remote rn auditor in Missouri is $30.94, according to ZipRecruiter salary data. Most workers in this role earn between $27.07 and $33.85 per hour, depending on experience, location, and employer.

What is the difference between Remote Rn Auditor vs Remote Rn Reviewer?

AspectRemote Rn AuditorRemote Rn Reviewer
CertificationsRN license, auditing certifications (e.g., CHAP, RAC)RN license, clinical review certifications
Work EnvironmentHealthcare organizations, insurance companies, auditing firmsHealthcare providers, insurance companies, utilization review
Primary ResponsibilitiesAuditing medical records for compliance, coding accuracy, and billingReviewing 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.

What Does a Remote RN Auditor Do?

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.

What are the key skills and qualifications needed to thrive as a Remote RN Auditor, and why are they important?

To thrive as a Remote RN Auditor, you need a strong background in nursing, clinical documentation, and auditing practices, typically with an active RN license and experience in medical record review. Familiarity with electronic health record (EHR) systems, coding standards (such as ICD-10 and CPT), and auditing software is essential. Attention to detail, strong analytical thinking, and effective written communication are standout soft skills in this role. These capabilities ensure accurate audits, regulatory compliance, and clear reporting in a remote healthcare environment.

How to make 300,000 as a nurse online?

A Remote RN Auditor can potentially earn $300,000 annually by gaining specialized certifications, such as Certified Professional Coder (CPC) or Certified Coding Specialist (CCS), and working for multiple healthcare organizations or insurance companies. Building expertise in medical billing, coding, and compliance, along with strong attention to detail and time management, can help increase earning potential in remote nursing roles. High earnings often require extensive experience and the ability to handle complex cases efficiently.

What are some common challenges faced by Remote RN Auditors, and how can they be effectively managed?

Remote RN Auditors often encounter challenges such as navigating complex electronic health record systems, ensuring data accuracy while working independently, and staying updated on frequently changing compliance regulations. To manage these, successful auditors develop strong organizational skills, maintain regular communication with team members, and participate in ongoing training. Proactively seeking clarification on ambiguous cases and leveraging available resources from their organization can also help maintain high-quality audit outcomes and job satisfaction.

Can an auditor work remotely?

Remote Rn Auditor roles are common, especially in healthcare and insurance industries, where audits can often be conducted using digital documentation and communication tools. These positions typically require strong organizational skills, familiarity with auditing software, and sometimes specific certifications, but they often offer flexible or fully remote work arrangements.

What is the highest paid remote nursing job?

The highest paid remote nursing jobs typically include roles such as Nurse Informaticists, Nurse Consultants, and Remote Nurse Auditors, with salaries often exceeding $100,000 annually. These positions require specialized skills, certifications, and experience in areas like healthcare technology, compliance, or case review, and they often involve independent work with flexible schedules.

What is a Remote RN Auditor?

A Remote RN Auditor is a registered nurse who reviews medical records, clinical documentation, and billing information to ensure compliance with healthcare regulations and standards—all while working remotely. Their primary focus is to verify accuracy in coding, billing, and adherence to clinical guidelines, often for insurance companies, hospitals, or healthcare organizations. They play a crucial role in identifying errors, preventing fraud, and improving the quality of patient care. This job typically requires an active RN license, strong attention to detail, and experience with healthcare compliance and auditing.

How do I become a nurse auditor?

To become a nurse auditor, typically you need a registered nurse (RN) license and experience in healthcare or coding. Many employers prefer candidates with knowledge of medical billing, coding, and auditing, and some may require certification such as the Certified Professional Medical Auditor (CPMA). Gaining relevant experience and obtaining certification can improve job prospects in this specialized field.
More about Remote Rn Auditor jobs
What are popular job titles related to Remote Rn Auditor jobs in Missouri? For Remote Rn Auditor jobs in Missouri, the most frequently searched job titles are:
What job categories do people searching Remote Rn Auditor jobs in Missouri look for? The top searched job categories for Remote Rn Auditor jobs in Missouri are:
What cities in Missouri are hiring for Remote Rn Auditor jobs? Cities in Missouri with the most Remote Rn Auditor job openings:
Remote Rn Auditor jobs near you
Infographic showing various Remote Rn Auditor job openings in Missouri as of June 2026, with employment types broken down into 4% Internship, 84% Full Time, 8% Part Time, and 4% Contract. Highlights an 100% Remote job distribution, with an average salary of $64,363 per year, or $30.9 per hour.
Inpatient DRG Sr. Reviewer

Inpatient DRG Sr. Reviewer

Zelis

Saint Louis, MO • On-site, Remote

$95K - $120K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 27 days ago

Zelis rating

7.6

Company rating: 7.6 out of 10

Based on 11 frontline employees who took The Breakroom Quiz

117th of 192 rated software companies

Job description

At Zelis, we Get Stuff Done. So, let's get to it!

A Little About Us

Zelis is modernizing the healthcare financial experience across payers, providers, and healthcare consumers. We serve more than 750 payers, including the top five national health plans, regional health plans, TPAs and millions of healthcare providers and consumers across our platform of solutions. Zelis sees across the system to identify, optimize, and solve problems holistically with technology built by healthcare experts - driving real, measurable results for clients.

A Little About You

You bring a unique blend of personality and professional expertise to your work, inspiring others with your passion and dedication. Your career is a testament to your diverse experiences, community involvement, and the valuable lessons you've learned along the way. You are more than just your resume; you are a reflection of your achievements, the knowledge you've gained, and the personal interests that shape who you are.

Position Overview

As part of the Price Optimization division, this role is responsible for conducting post-service, pre-payment and post pay comprehensive inpatient DRG Quality Assurance reviews in an effort to increase the savings achieved for Zelis clients. Conduct reviews on inpatient DRG claims as they compare with medical records utilizing ICD-10 Official Coding Guidelines, AHA Coding Clinic evidence based clinical criteria and client specific coverage policies.

What you'll do:

  • Perform comprehensive inpatient DRG validation Quality Assurance reviews to determine accuracy of the DRG billed, based on industry standard coding guidelines and the clinical evidence supplied by the provider in the form of medical records such as physician notes, lab tests, images (x-rays etc.), and with due consideration to any applicable medical policies, medical best practice, etc.
  • Implement and conduct quality assurance program to ensure accurate results to our clients
  • Manage assigned claims and claim report, adhering to client turnaround time, and department Standard Operating Procedures
  • Serve as the Subject Matter Expert on DRG validation to team members and other departments within the organization
  • Prepare and conduct training for new team members
  • Identify new DRG coding concepts to expand the DRG product
  • Meet and/or exceed all internal and department productivity and quality standards
  • Must remain current in all national coding guidelines including Official Coding Guidelines, AHA Coding Clinic and AMA CPT Assistant
  • Recommend efficiencies and process improvements to improve departmental procedures
  • Maintain awareness of and ensure adherence to Zelis standards regarding privacy

What you'll bring to Zelis:

  • Registered Nurse licensure preferred
  • Inpatient Coding Certification required (i.e., CCS, CIC, RHIA, RHIT)
  • 5+ years reviewing and/or auditing ICD-10 CM, MS-DRG and APR-DRG claims preferred
  • Solid understanding of audit techniques, identification of revenue opportunities and financial negotiation with providers
  • Experience and working knowledge of Health Insurance, Medicare guidelines and various healthcare programs
  • Strong understanding of hospital coding and billing rules
  • Clinical and critical thinking skills to evaluate appropriate coding
  • Strong organization skills with attention to detail
  • Excellent communication skills both verbal and written, and skilled at developing and maintaining effective working relationships.
  • Demonstrated thought leadership and motivation skills, a self-starter with an ability to research and resolve issues

Please note at this time we are unable to proceed with candidates who require visa sponsorship now or in the future.

Location and Workplace Flexibility

We have offices in Atlanta GA, Boston MA, Morristown NJ, Plano TX, St. Louis MO, St. Petersburg FL, and Hyderabad, India. We foster a hybrid and remote friendly culture, and all our employee's work locations are based on the needs of the position and determined by the Leadership team. In-office work and activities, if applicable, vary based on the work and team objectives in accordance with Company policies.

Base Salary Range

$95,000.00 - $120,650.00

At Zelis we are committed to providing fair and equitable compensation packages. The base salary range allows us to make an offer that considers multiple individualized factors, including experience, education, qualifications, as well as job-related and industry-related knowledge and skills, etc. Base pay is just one part of our Total Rewards package, which may also include discretionary bonus plans, commissions, or other incentives depending on the role.

Zelis' full-time associates are eligible for a highly competitive benefits package as well, which demonstrates our commitment to our employees' health, well-being, and financial protection. The US-based benefits include a 401k plan with employer match, flexible paid time off, holidays, parental leaves, life and disability insurance, and health benefits including medical, dental, vision, and prescription drug coverage.

Equal Employment Opportunity
Zelis is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
We welcome applicants from all backgrounds and encourage you to apply even if you don't meet 100% of the qualifications for the role. We believe in the value of diverse perspectives and experiences and are committed to building an inclusive workplace for all.

Accessibility Support
We are dedicated to ensuring our application process is accessible to all candidates. If you are a qualified individual with a disability or a disabled veteran and require a reasonable accommodation with any part of the application and/or interview process, please email TalentAcquisition@zelis.com.

Disclaimer

The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. All personnel may be required to perform duties outside of their normal responsibilities, duties, and skills from time to time.

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