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Remote Rn Auditor Jobs in Ohio (NOW HIRING)

TriHealth

Supervisor Revenue Integrity

Cincinnati, OH · On-site +1

Other Nursing License (LPN, RN, BSN) Required or * CPC - Certified Professional Coder Required Job Overview: The Supervisor of Revenue Integrity is responsible for overseeing charge auditing, charge ...

TriHealth

Supervisor Revenue Integrity

Cincinnati, OH · Remote

Other Nursing License (LPN, RN, BSN) Required or * CPC - Certified Professional Coder Required Job Overview: The Supervisor of Revenue Integrity is responsible for overseeing charge auditing, charge ...

Medpace, Inc.

Clinical Data Coder

Cincinnati, OH · On-site +1

$18 - $22.75/hr

BSN and RN with applicable experience is required, or more advanced clinical degree (including PharmD) is accepted; * Strong critical thinking, organizational, and multi-tasking skills required;

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Remote Rn Auditor information

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$18

$31

$44

How much do remote rn auditor jobs pay per hour?

As of Sep 7, 2026, the average hourly pay for remote rn auditor in Ohio is $31.36, according to ZipRecruiter salary data. Most workers in this role earn between $27.40 and $34.28 per hour, depending on experience, location, and employer.

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.

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?

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.

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.

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.

How do I become a remote RN auditor?

To become a remote RN auditor, you typically need a valid registered nurse license, relevant experience in healthcare or medical record review, and knowledge of coding and compliance standards such as HIPAA. Many employers also prefer candidates with certifications like Certified Professional Medical Auditor (CPMA) or Certified Coding Specialist (CCS). Strong attention to detail and proficiency with electronic health record systems are essential for success in this role.
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Infographic showing various Remote Rn Auditor job openings in Ohio as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution, with an average salary of $65,234 per year, or $31.4 per hour.

Sr Quality Improvement, HEDIS Spec, Health Plan Interventions (Remote In Ohio)

Molina Healthcare

Columbus, OH • On-site, Remote

$54K - $107K/yr

Full-time

This job post has expired 3 days ago. Applications are no longer accepted.

Molina Healthcare rating

8.0

Company rating: 8.0 out of 10

Based on 199 frontline employees who took The Breakroom Quiz

172nd of 315 rated insurance

Job description


Molina Healthcare of Ohio is hiring for a Sr Quality Improvement/HEDIS Specialist on our Health Plan Community Interventions team.
This role is remote however candidates must live in Ohio.
This role is laser focused on Quality Improvement using QI Science. This role will be assigned a primary population stream and will be expected to support improvement work for Medicare Stars Measures.
Highly qualified candidates will have the following experience-
  • Using the specific models for improvement required by the state of Ohio
  • Experience with a formal model like IHI or Lean or Six Sigma, Green or Yellow Belt Improvement
  • Power BI is helpful but expert level is not required
  • Familiarity with Medicare (Ideally the Duals population)
  • Familiarity with QI Science, Health Equity, Population Health, Health Management

This role also provides senior level support for clinical quality member intervention activities. Responsible for the developing and implementing new and existing member intervention initiatives including all lines of business (Medicare, Marketplace, Medicaid, etc.). Executes health plan member and community quality-focused interventions and programs in accordance with established program standards, and federal/state/National Committee for Quality Assurance (NCQA) regulations. Conducts data collection, monitors intervention activity including key performance measurement activities, reports intervention outcomes, and supports continuous improvement of intervention processes and outcomes.
Essential Job Duties
  • Implements evidence-based and data-informed key member intervention strategies including initiating and managing member and/or community interventions (e.g., removing barriers to care) and other federal and state quality initiatives.
  • Monitors and ensures that key member intervention activities are completed on time and accurately, and presents results to key departmental management and other applicable Molina departments.
  • Writes narrative reports to interpret regulatory specifications, explains programs and results of programs, and documents findings and limitations of department interventions.
  • Creates, manages, and/or compiles required documentation necessary to maintain critical program milestones, deadlines, and deliverables.
  • Participates in quality improvement (QI) activities, meetings, and discussions with and between other departments within the organization.
  • Supports provision of high-quality clinical care and services by facilitating/building strategic relationships with community-based organizations (CBOs).
  • Evaluates quality project/program activities and results to identify opportunities for improvement.
  • Raises gaps in processes that may require remediation to quality leadership.
  • Provides support for quality-related projects.
  • Provides training and support to new and existing quality member interventions team members.
  • Demonstrates flexibility when it comes to change management and maintains a positive outlook.
  • This position may require same day out of office travel 0 - 80% of the time, depending upon state-specific needs.
  • This position may require multi-day overnight travel on occasion, depending upon state-specific needs.

Required Qualifications
  • At least 3 years of experience in health care, and at least 2 years of experience in health plan quality member interventions in a managed care setting, or equivalent combination of relevant education and experience.
  • Demonstrated solid business writing experience.
  • Proficiency with data analysis, manipulation and interpretation.
  • Intermediate knowledge and understanding of HEDIS and NCQA.
  • Critical-thinking, problem-solving and analytical skills.
  • Attention to detail and organizational skills.
  • Ability to navigate change with flexibility and a positive outlook.
  • Ability to work independently in a fast-paced, deadline-driven environment.
  • Effective verbal and written communication skills.
  • Microsoft Office suite and applicable software programs proficiency, and ability to learn new information systems and software programs.

Preferred Qualifications
  • Experience with data reporting, analysis, and interpretation.
  • Experience with Medicaid, Medicare, and/or Marketplace government-sponsored programs.
  • Certified Professional in Health Quality (CPHQ).
  • Certified HEDIS Compliance Auditor (CHCA).
  • Registered Nurse (RN). If licensed, license must be active and unrestricted in state of practice.

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

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About Molina Healthcare

Sourced by ZipRecruiter

Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Long Beach, CA, US

Year founded

1980

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