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Remote Rn Auditor Jobs in Texas (NOW HIRING)

MMC Group

DRG Auditor

San Antonio, TX · Remote

... remote DRG Validation Auditors. As members of the DRG Validation Team and working remotely ... Follow proper procedure for referral to Clinical Nurse Auditor or Physician Advisor. * Utilize ...

CERiS

Clinical Review QC Auditor

Fort Worth, TX · On-site +1

$68K - $104K/yr

Experience in the OR, ICU, or ER as an RN highly preferred * Required minimum of 2 year of recent ... Remote Equal Opportunity Employer This employer is required to notify all applicants of their ...

Corvel

Clinical Review QC Auditor

Fort Worth, TX · On-site +1

$68K - $104K/yr

Experience in the OR, ICU, or ER as an RN highly preferred * Required minimum of 2 year of recent ... Remote Equal Opportunity Employer This employer is required to notify all applicants of their ...

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Remote Rn Auditor information

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How much do remote rn auditor jobs pay per hour?

As of Jun 15, 2026, the average hourly pay for remote rn auditor in Texas is $30.73, according to ZipRecruiter salary data. Most workers in this role earn between $26.88 and $33.61 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.
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Remote Rn Auditor jobs near you
Infographic showing various Remote Rn Auditor job openings in Texas as of June 2026, with employment types broken down into 82% Full Time, and 18% Part Time. Highlights an 100% Remote job distribution, with an average salary of $63,927 per year, or $30.7 per hour.
DRG Auditor

DRG Auditor

MMC Group

San Antonio, TX • Remote

Full-time

Posted 26 days ago

Job description


Job Description:

A leader in providing clinical auditing services to public and commercial healthcare payers throughout the US, has openings for remote DRG Validation Auditors. As members of the DRG Validation Team and working remotely, incumbents will be responsible for reviewing medical records to determine the accuracy of coding and reimbursement for clinical services rendered to beneficiaries of various health plans, including Commercial, Medicare, and Medicaid Clients. DRG Validation Auditors are charged with rendering appropriate, well-supported, and thoroughly-documented decisions, which may result in identification of improper payments (overpayments and underpayments) on paid claims on behalf of the client from various providers of clinical services, including but not limited to acute care, long-term acute care, acute rehabilitation, and skilled nursing facilities, as well as other provider types and care settings. Initially, DRG Validation Auditors are prepared for the role through a detailed, well-defined training process, gaining knowledge and skills in methods for review of medical records and other provider documentation. Ongoing training and education are provided specific to audit processes, coding and reimbursement changes, and other topics as well. The DRG Validation Auditor reports to a DRG Validation Team Leader, who provides support, feedback, and guidance to DRG Validation Auditors. Moreover, quality assurance is provided through a well-defined review and quality management program performed by the Professional Development Team.


Specifically, DRG Validation Auditors will be responsible for the following:


  • Review inpatient medical records to validate the admit order, assignment and sequencing of ICD9-CM diagnosis and procedure codes, discharge status codes, and DRG assignment.

  • Provide a detailed rationale for every medical record review resulting in a DRG Review Results letter, including supporting references.

  • 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 team on claims selection criteria.

  • Verify data received from client and work to resolve discrepancies.

  • If the contract requires onsite review, interact with Providers and other personnel in a professional manner.

  • Follow policies and processes

  • Comply with department standards regarding productivity and audit quality.

  • Perform other duties as assigned.



To be considered for these challenging roles, applicants must have a majority of the following skills, knowledge and abilities:


  • Possess current AHIMA credentials (RHIT/RHIA/CCS), with current CCS preferred

  • Demonstrate extensive knowledge of ICD-9-CM coding and DRG reimbursement, with a minimum of five years of inpatient coding experience

  • Have an understanding of Medicare, Medicaid, and commercial provider reimbursement methodologies, and possess strong data analysis skills

  • Working knowledge of computer functions and applications such as Microsoft Office (Outlook, Word, Excel) and Windows operating systems

  • Ability to write a well-reasoned review in a narrative style, with accurate spelling, grammar, punctuation, and sentence structure

  • Ability to adapt to changing priorities in order to meet Client requirements and productivity standards and deadlines

  • Ability to travel for additional training and on-site reviews on an as-needed basis

  • Since incumbents will work from their home-based offices, they must have their own access to high-speed Internet connectivity