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Remote Rn Auditor Jobs in Harrisburg, PA (NOW HIRING)

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Remote Rn Auditor information

See Harrisburg, PA salary details

$19

$32

$46

How much do remote rn auditor jobs pay per hour?

As of Aug 27, 2026, the average hourly pay for remote rn auditor in Harrisburg, PA is $32.57, according to ZipRecruiter salary data. Most workers in this role earn between $28.46 and $35.58 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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Remote Compliance Auditor

The CKHobbie Group

Harrisburg, PA • On-site, Remote

Full-time

Re-posted 25 days ago

Job description


Position Overview:
We are seeking a Registered Nurse (RN) to review and evaluate medical necessity, appropriateness, quality, and compliance of services rendered by providers. This role involves claims analysis, provider audits, fraud detection, and regulatory enforcement to ensure compliance with state and federal regulations.
Key Responsibilities:
  • Analyze claims data, medical records, and provider documentation to identify discrepancies, fraud, or non-compliance.
  • Conduct retrospective case reviews, on-site provider audits, and recipient interviews.
  • Review billing practices for upcoding, duplicate billing, and unbundling of services using ICD-10, CPT, and HCPCS manuals.
  • Prepare reports, case findings, and recommend sanctions when violations are identified.
  • Coordinate and participate in teleconferences, hearings, and legal proceedings with the Office of General Counsel and other agencies.
  • Respond to provider complaints and compliance inquiries via hotline, email, and official reports.
  • Maintain case tracking systems and contribute to policy recommendations and process improvements.
  • Travel as needed for on-site reviews, meetings, and training.
Requirements:
  • Registered Nurse (RN) license (required).
  • Experience with claims analysis, medical records review, and compliance investigations.
  • Knowledge of MA regulations, medical billing, and fraud detection.
  • Proficiency in Microsoft Office
  • Strong written and verbal communication skills for reporting and testimony.
  • Ability to work independently, maintain confidentiality, and manage case files efficiently.
  • Must be able to travel to Harrisburg, PA for training
Preferred Qualifications:
  • Experience with Managed Care Organizations (MCOs) and HCBS providers.
  • Familiarity with PROMISe claims systems and Fraud Abuse Detection Systems (FADS).
  • Prior experience in legal proceedings, hearings, or administrative compliance

This is an opportunity to play a critical role in ensuring healthcare integrity and protecting public funds. Apply today to join our team!

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