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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 ...

Careforth

RN Care Manager

Lynn, MA · Remote

$79K - $97K/yr

Through a combination of in-person home visits, remote coaching and our proprietary digital ... As an RN Care Manager, you'll assess needs, create individualized care plans, conduct home visits ...

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 ...

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 ...

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All JobsRemote Rn Auditor JobsRemote Rn Auditor Jobs in Boston, MA

Remote Rn Auditor information

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How much do remote rn auditor jobs pay per hour?

As of Jun 25, 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.

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 Boston, MA as of June 2026, with employment types broken down into 13% Full Time, 27% Part Time, 1% Temporary, and 59% Contract. Highlights an 48% Physical, 3% Hybrid, and 49% Remote job distribution, with an average salary of $74,545 per year, or $35.8 per hour.
Program Integrity Clinical Compliance Auditor

Program Integrity Clinical Compliance Auditor

UnitedHealth Group

Boston, MA • Remote

Full-time

Retirement

Posted 3 days ago

UnitedHealth Group rating

7.6

Company rating: 7.6 out of 10

Based on 141 frontline employees who took The Breakroom Quiz

189th of 875 rated healthcare providers

Job description

This position is Remote in Massachusetts. You will have the flexibility to work remotely* as you take on some tough challenges.

Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start Caring. Connecting. Growing together.

The Program Integrity Clinical Compliance Auditor will be responsible for performing compliance reviews of medical and administrative documentation to identify instances of healthcare fraud and/or wasteful and abusive conduct by health care providers who submit claims for payment. This position will utilize information from claims data analysis, plan members, the medical community, law enforcement, employee conduct, and confidential investigations in order to document relevant findings.  The Sr. Recovery Resolution Analyst will conduct site visits and desk audits of provider claims, and medical and administrative records, to gather and analyze all necessary information to determine whether subject adhered to state and federal compliance policies, reimbursement policies, and contract compliance.  The Sr. Recovery Resolution Analyst will present and discuss audit findings with client and input information into Optum audit workflow tools and the client's case tracking system.  Where applicable, the Auditor will support appeal and fraud investigation activities.

This position is full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00 am - 5:00 pm local time. It may be necessary, given the business need, to work occasional overtime.

We offer weeks of on-the-job training. The hours of the training will be aligned with your schedule.

Primary Responsibilities:

  • Review medical and administrative records for audit/compliance review
  • Travel to provider sites up to 25%/month to collect records and engage with providers
  • Present and participate in discussions with the client regarding audit observations and findings
  • Collaborate with a team of 2-5 auditors to complete reviews
  • Enter audit findings data and notes in online/electronic platform using Excel-based templates
  • Attend and participate in dispute reviews and administrative hearings
  • Demonstrated written and verbal communications skills
  • Demonstrated customer service skills

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:

  • High School Diploma / GED OR equivalent work experience
  • Must be 18 years of age OR older
  • Nurse licensure (RN or LPN) with a current, active, and unrestricted license in Massachusetts
  • Must have a Valid Driver's license
  • 2 years of experience reviewing health care documentation in a clinical or administrative role
  • Experience with MS Office Suite, specifically Word, PowerPoint, and Excel (including familiarity with basic formulas and data analysis)
  • Ability to travel up to 25% of the time within the state of Massachusetts as business needs dictate
  • Ability to work full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00 am - 5:00 pm local time. It may be necessary, given the business need, to work occasional overtime

Preferred Qualifications:

  • Clinical or administrative experience in long term care, for example, nursing facility care delivery/administration and/or community-based LTC service programs like Home Health
  • Experience in claim processing, healthcare provider information, and healthcare billing practices
  • Experience working in a remote/telecommute workspace
  • Working knowledge of medical terminology and claim coding with familiarity of CPT-4, HCPCs and ICD-10 code terminology
  • Familiarity with Medicaid program and/or billing requirements

Telecommuting Requirements:

  • Reside within Massachusetts.
  • Ability to keep all company sensitive documents secure (if applicable)
  • Required to have a dedicated work area established that is separated from other living areas and provides information privacy.
  • Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service.

*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 hourly pay for this role will range from $29.00 to $52.00 per hour 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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