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Remote Rn Auditor Jobs in Boston, MA (NOW HIRING)

VITRA Health

Nurse Compliance Manager

Boston, MA · Remote

$140K - $150K/yr

This role requires a strong clinical background (RN required), deep knowledge of healthcare ... Conduct and supervise onsite and remote audits of field operations, caregiver performance, and ...

York Risk Services

RN Field Case Manager

Boston, MA · Remote

$84K - $107K/yr

Must be an RN and prefers 1.5 years of prior workers compensation experience. PRIMARY PURPOSE OF ... remote work environment that allows face to face interaction with injured workers and medical ...

Sedgwick

RN Field Case Manager

Boston, MA · Remote

$84K - $107K/yr

Must be an RN and prefers 1.5 years of prior workers compensation experience. PRIMARY PURPOSE OF ... remote work environment that allows face to face interaction with injured workers and medical ...

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Remote Rn Auditor information

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How much do remote rn auditor jobs pay per hour?

As of Jul 31, 2026, the average hourly pay for remote rn auditor in Boston, MA is $35.84, according to ZipRecruiter salary data. Most workers in this role earn between $31.35 and $39.18 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.

Can you work remotely as an auditor?

Remote Rn Auditor positions are available and typically involve reviewing healthcare documentation and compliance from a home office. These roles often require strong computer skills, familiarity with auditing software, and adherence to confidentiality standards, making remote work feasible for qualified professionals.

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 increase earnings by gaining specialized certifications, such as in coding or compliance, and working for multiple clients or agencies to maximize income. Building a strong reputation and leveraging telehealth platforms can also lead to higher-paying opportunities, but reaching $300,000 annually typically requires extensive experience, advanced skills, and possibly additional roles or consulting work.

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 highest paying remote nurse job?

The highest paying remote nurse jobs typically include roles such as remote nurse anesthetists, nurse practitioners, and clinical nurse specialists, with salaries often exceeding $100,000 annually. These positions usually require advanced certifications, specialized skills, and experience in telehealth or case management environments.

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 you become a nurse auditor?

To become a nurse auditor, you typically need a registered nurse (RN) license and experience in healthcare or medical billing. Many employers prefer candidates with knowledge of insurance claims, coding, and auditing procedures, and some may require certification such as the Certified Professional Medical Auditor (CPMA).
More about Remote Rn Auditor jobs
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Remote Rn Auditor jobs near you
Infographic showing various Remote Rn Auditor job openings in Boston, MA as of July 2026, with employment types broken down into 2% Locum Tenens, 89% Full Time, 6% Part Time, 2% Contract, and 1% Nights. Highlights an 87% Physical, 6% Hybrid, and 7% Remote job distribution, with an average salary of $74,545 per year, or $35.8 per hour.

Sr Utilization Management Nurse RN - Remote

UnitedHealth Group

Boston, MA • On-site, Remote

Full-time

Retirement

Posted 14 days ago

UnitedHealth Group rating

7.6

Company rating: 7.6 out of 10

Based on 146 frontline employees who took The Breakroom Quiz

185th of 885 rated healthcare providers

Job description

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
We serve the Commonwealth of Massachusetts in partnering with onsite audits and projects. We have collaborative team scheduling and there is an occasional opportunity for remote work based on business needs.
As a Sr Utilization Management Nurse in the Boston MA Regional Area, the role centers on ensuring the accuracy of medical record coding, supporting proper payment to nursing facilities, and promoting quality patient care. Responsibilities include collaborating with peers and providers to discuss care details, reviewing clinical information for appropriateness, and communicating findings and rationale to medical professionals and the broader community. Additionally, the nurse educates stakeholders about audit results and corrective plans, ensures compliance with HIPAA guidelines, and leverages clinical expertise to guide decisions and optimize patient outcomes.
Qualified candidates must live in the Boston MA Regional Area to perform the daily travel responsibilities. For this role, there will be no weekends, no holidays, and no on-call work.
If you live in Boston MA, you will have the flexibility to work remotely* as you take on some tough challenges.
Primary Responsibilities:
  • Audit entire medical record for accuracy of the coding on the MDS to support payment to the nursing facility
  • Auditing anti-psychotic therapy for quality review
  • Discuss Patient Care specifics with peers or providers in overall patient care and benefits
  • Communicate clinical findings and present rationale for decisions to medical professionals and members at the appropriate level for understanding
  • Review the entire medical record for accuracy, and appropriate clinical treatment
  • Communicate findings of audits to client, and community as needed
  • Education of findings with community, identifying plans for correction
  • Comply with HIPAA guidelines related to Personal Health Information (PHI) when communicating with others
  • Leverage experience and understanding of disease pathology to review chart/clinical information, ask appropriate questions, and identify appropriate course of care in a given situation
  • Perform medical chart review that includes a review of current and prior patient conditions, documents, and evaluations, and relevant social and economic situations to identify patients' needs
  • Research and identify information needed to review assessment for accuracy, respond to questions, or make recommendations
  • Apply knowledge of pharmacology and clinical treatment protocol to determine appropriateness of care
  • Work collaboratively with peers/team members and other levels or segments within Optum, UHC, or UBH (e.g. Case Managers, Field Care Advocates) to identify appropriate course of action (e.g. Appropriate care, follow up course of action, make referral)
  • Required to travel within geographic territory (state of Massachusetts) at least 90% of the time (some weeks will require 100% travel as business needs dictate) and assist when needed throughout the state of Massachusetts for audits. (Audits will be conducted onsite)

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
  • Registered Nurse (RN) with a current, active, unrestricted RN License in Massachusetts
  • Currently have OR be able to obtain an RAC/CT MDS certification (must have completed certification prior to start date)
  • 4+ years of nursing experience, specifically in long-term care and/or medical record review with knowledge of Medicare and Medicaid
  • Recent long-term care MMQ, MDS, staff development or management experience (in long-term care)
  • Experience working within medical insurance and/or healthcare industries
  • Experience analyzing inventory, researching, identifying, and resolving issues
  • Experience with defining and managing processes within a team
  • Experience trouble shooting issues for users within teams, IT, and/or business partners
  • Proven knowledge of healthcare insurance industry (Medicaid, Medicare, CMS)
  • Demonstrated knowledge of process flow of UM, including prior authorization, concurrent authorization, and/or clinical appeal and guidance reviews
  • Must live in the Boston MA Regional Area to conduct daily travel requirements
  • Ability to travel within geographic territory (state of Massachusetts) at least 90% of the time (some weeks will require 100% travel as business needs dictate) and assist when needed throughout the state of Massachusetts for audits. (Audits will be conducted onsite)
  • Must have reliable transportation and be able to provide proof of a valid, unrestricted Driver's License and current Auto Insurance

Preferred Qualifications:
  • Proven knowledge of Medicaid and Medicare benefit products including applicable state regulations
  • Demonstrated knowledge of applicable area of specialization
  • Demonstrated knowledge of Massachusetts DPH guidelines
  • Demonstrated knowledge of computer functionality, navigation, and software applications
  • Proficiency with Microsoft Office Suite
  • Proficient written and verbal skills

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $72,800 - $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

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