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Remote Rn Auditor Jobs in Anaheim, CA (NOW HIRING)

Zócalo Health

RN Case Manager

Los Angeles, CA · Remote

$85K/yr

RN Case Manager Remote (Full Time) *Must reside in California* Compensation: $85,000 About Us Zócalo Health is a tech-enabled, community-oriented primary care organization serving people who have ...

Imh

RN Care Manager

West Covina, CA · Remote

$41.20 - $62.17/hr

The RN Hospital Care Manager I delivers comprehensive care management services to designated ... If applying for a remote or hybrid role, this includes remote work expectations related to ...

Molina Healthcare

Medical Review Nurse (RN)

Long Beach, CA · Remote

$29.05 - $56.64/hr

... LTSS), claims auditing, medical necessity review and/or coding experience, or equivalent combination of relevant education and experience. Registered Nurse (RN). License must be active and ...

Corvel

Utilization Review Supervisor RN

Rancho Cucamonga, CA · Remote

$77K - $120K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Responsible for directing a ... Current RN licensure in state of operation * 3 or more years of recent clinical experience ...

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Remote Rn Auditor information

See Anaheim, CA salary details

$20

$34

$48

How much do remote rn auditor jobs pay per hour?

As of Aug 15, 2026, the average hourly pay for remote rn auditor in Anaheim, CA is $34.54, according to ZipRecruiter salary data. Most workers in this role earn between $30.19 and $37.74 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.

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.

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 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.

Can you work remotely as a remote RN auditor?

Yes, remote RN auditors can often work from home, as the role primarily involves reviewing medical records and documentation electronically. Strong computer skills, familiarity with auditing software, and relevant nursing licensure are typically required, and employers may set specific remote work policies or schedules.
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Remote Rn Auditor jobs near you
Infographic showing various Remote Rn Auditor job openings in Anaheim, CA as of August 2026, with employment types broken down into 79% Full Time, and 21% Part Time. Highlights an 64% In-person, and 36% Remote job distribution, with an average salary of $71,836 per year, or $34.5 per hour.

Remote Auditor, Healthcare Services (RN) - Residency in TX Required

Molina Healthcare

Long Beach, CA • Remote

$29.05 - $56.64/hr

Full-time

This job post has expired 1 day 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

164th of 308 rated insurance

Job description

JOB DESCRIPTION 

Summary of highly qualified candidates:

  • Must reside in TX and have an active TX RN license in good standing.
  • Focus of these audits is on the functions of the Utilization Department.
  •  Experience in UM with clinical reviews and knowledge of MCG Clinical Criteria is required.
  • Experience with NCQA, EQRO, and HHS ACUR audits, case file preparation and presentation is strongly preferred.

Job Summary

Provides support for healthcare services clinical auditing activities. Performs audits for clinical functional areas in alignment with regulatory requirements - ensuring quality compliance and desired member outcomes. Contributes to overarching strategy to provide quality and cost-effective member care. 

Essential Job Duties


Performs audits in utilization management, care management, member assessment, behavioral health, and/or other clinical teams, and monitors clinical staff for compliance with National Committee for Quality Assurance, Centers for Medicare and Medicaid Services (CMS), and state/federal guidelines and requirements. May also perform non-clinical system and process audits as needed. 
Audits for clinical gaps in care from a medical and/or behavioral health perspective to ensure member needs are being met. 
Assesses clinical staff regarding appropriate clinical decision-making. 
Reports monthly outcomes, identifies areas of re-training for staff, and communicates findings to leadership. 
Ensures auditing approaches follow a Molina standard in approach and tool use. 
Maintains member/provider confidentiality in compliance with the Health Insurance Portability and Accountability Act (HIPAA), and professionalism in all communications. 
Adheres to departmental standards, policies and protocols. 
Maintains detailed records of auditing results. 
Assists healthcare services training team with developing training materials or job aids as needed to address findings in audit results. 
Meets minimum production standards related to clinical auditing. 
May conduct staff trainings as needed.  Communicates with quality and/or healthcare services leadership regarding issues identified, and works collaboratively to subsequently resolve/correct. 

Required Qualifications


At least 2 years health care experience, with at least 1 year experience in utilization management, care management, and/or managed care, or equivalent combination of relevant education and experience. 
Registered Nurse (RN). License must be active and unrestricted in state of practice. 
Strong attention to detail and organizational skills. 
Strong analytical and problem-solving skills. 
Ability to work in a cross-functional, professional environment. 
Ability to work on a team and independently. 
Excellent verbal and written communication skills. 
Microsoft Office suite/applicable software program(s) proficiency. 

Preferred Qualifications


Utilization management, care management, behavioral health and/or long-term services and supports (LTSS) clinical review/auditing experience.
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

Pay Range: $29.05 - $56.64 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Employment Type: Full Time

What Molina Healthcare employees say

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Hours and flexibility

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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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