Location: This is a remote position, Monday - Friday from 8:30am - 5pm. What You'll Do ... RN licensure from the United States and in the state of hire, OR, active compact multi-state ...
Location: This is a remote position, Monday - Friday from 8:30am - 5pm. What You'll Do ... RN licensure from the United States and in the state of hire, OR, active compact multi-state ...
Location: This is a remote position, Monday - Friday from 8:30am - 5pm. What You'll Do ... RN licensure from the United States and in the state of hire, OR, active compact multi-state ...
Location: This is a remote position, Monday - Friday from 8:30am - 5pm. What You'll Do ... RN licensure from the United States and in the state of hire, OR, active compact multi-state ...
CircleLink Health is seeking top-tier Compact Registered Nurses for a remote role focused on managing Medicare patients and delivering clinical calls. The position offers flexible scheduling and a ...
CircleLink Health is seeking top-tier Compact Registered Nurses for a remote role focused on managing Medicare patients and delivering clinical calls. The position offers flexible scheduling and a ...
Registered Medical Review Nurse - Training and Quality Control Coordinator
Columbia, SC · On-site +1
$18.25 - $25.25/hr
Columbia, SC / Remote or Hybrid as assigned Position Summary Broadway Ventures is seeking a ... Background in medical review, utilization review, quality assurance, auditing, or clinical ...
Registered Medical Review Nurse - Training and Quality Control Coordinator
Columbia, SC · On-site +1
$18.25 - $25.25/hr
Columbia, SC / Remote or Hybrid as assigned Position Summary Broadway Ventures is seeking a ... Background in medical review, utilization review, quality assurance, auditing, or clinical ...
Medical Review Auditor
Columbia, SC · Remote
$36/hr
South Carolina or bordering North Carolina; potential for remote work, but onsite preferred ... Associate Degree in Nursing or Health Information Management or Graduate of an Accredited School of ...
Quick apply
Medical Review Auditor
Columbia, SC · Remote
$36/hr
South Carolina or bordering North Carolina; potential for remote work, but onsite preferred ... Associate Degree in Nursing or Health Information Management or Graduate of an Accredited School of ...
Registered Medical Review Nurse - Training and Quality Control Coordinator
Columbia, SC · On-site +1
$18.25 - $25.25/hr
Columbia, SC / Remote or Hybrid as assigned Position Summary Broadway Ventures is seeking a ... Background in medical review, utilization review, quality assurance, auditing, or clinical ...
Quick apply
Registered Medical Review Nurse - Training and Quality Control Coordinator
Columbia, SC · On-site +1
$18.25 - $25.25/hr
Columbia, SC / Remote or Hybrid as assigned Position Summary Broadway Ventures is seeking a ... Background in medical review, utilization review, quality assurance, auditing, or clinical ...
Director, Healthcare Services - REMOTE
Columbia, SC · Remote
$88.45K - $168.98K/yr
Ensures monthly auditing occurs with appropriate follow-up. Engages in clinical training activities ... Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Licensed ...
Director, Healthcare Services - REMOTE
Columbia, SC · Remote
$88.45K - $168.98K/yr
Ensures monthly auditing occurs with appropriate follow-up. Engages in clinical training activities ... Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Licensed ...
Registered Nurse
Columbia, SC · Remote
$40 - $60/hr
MDs, PAs, and Nurses. Benefits ... This a full-time or part-time REMOTE position * You'll be able to choose which projects you want to ...
Quick apply
Registered Nurse
Columbia, SC · Remote
$40 - $60/hr
MDs, PAs, and Nurses. Benefits ... This a full-time or part-time REMOTE position * You'll be able to choose which projects you want to ...
RN
Columbia, SC · Remote
$40 - $60/hr
MDs, PAs, and Nurses. Benefits ... This a full-time or part-time REMOTE position * You'll be able to choose which projects you want to ...
Quick apply
RN
Columbia, SC · Remote
$40 - $60/hr
MDs, PAs, and Nurses. Benefits ... This a full-time or part-time REMOTE position * You'll be able to choose which projects you want to ...
Medical Review Nurse -UM/Post Appeals (Michigan RN license req)
Columbia, SC · Remote
$29.05 - $67.97/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 ...
Medical Review Nurse -UM/Post Appeals (Michigan RN license req)
Columbia, SC · Remote
$29.05 - $67.97/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 ...
Case Manager, Registered Nurse (Oncology experience required)
Columbia, SC · Remote
$54.10K - $155.54K/yr
Position Summary This is a remote work from home role anywhere in the US with virtual training ... A RN who resides in a compact state is required to have an active multistate license through the ...
Case Manager, Registered Nurse (Oncology experience required)
Columbia, SC · Remote
$54.10K - $155.54K/yr
Position Summary This is a remote work from home role anywhere in the US with virtual training ... A RN who resides in a compact state is required to have an active multistate license through the ...
Compact (NLC) license and/or California RN license required, depending on assignment Physical Demand & Work Environment * Fully remote/home-based role * Private, quiet, and secure home office free ...
Compact (NLC) license and/or California RN license required, depending on assignment Physical Demand & Work Environment * Fully remote/home-based role * Private, quiet, and secure home office free ...
Medical Review Nurse -UM/Post Appeals (Michigan RN license req)
Columbia, SC · Remote
$29.05 - $67.97/hr
... auditing, medical necessity review and/or coding experience, or equivalent combination of relevant education and experience. • Registered Nurse (RN). License must be active and unrestricted in ...
Medical Review Nurse -UM/Post Appeals (Michigan RN license req)
Columbia, SC · Remote
$29.05 - $67.97/hr
... auditing, medical necessity review and/or coding experience, or equivalent combination of relevant education and experience. • Registered Nurse (RN). License must be active and unrestricted in ...
At AMC Health, we are transforming healthcare through advanced remote patient monitoring and ... Collaborate with clinical management, RN Care Managers, providers, and interdisciplinary care teams ...
At AMC Health, we are transforming healthcare through advanced remote patient monitoring and ... Collaborate with clinical management, RN Care Managers, providers, and interdisciplinary care teams ...
Inpatient Audit Specialist PRN Sign on Bonus
Columbia, SC · Remote
$22.25 - $25.25/hr
This role is fully remote with a flexible schedule, allowing you to help shape the future of health ... auditing * Associate or Bachelor's degree from an AHIMA-certified HIM or Nursing Program, or ...
Inpatient Audit Specialist PRN Sign on Bonus
Columbia, SC · Remote
$22.25 - $25.25/hr
This role is fully remote with a flexible schedule, allowing you to help shape the future of health ... auditing * Associate or Bachelor's degree from an AHIMA-certified HIM or Nursing Program, or ...
Looking for Clinical Analyst & Coding Specialist- W2 Only (SC Resident) - 100% Remote
Columbia, SC · Remote
Title: Clinical Analyst & Coding Specialist- W2 Location: 100% Remote Duration: 12+ Months from ... An RN is required for the medical coding reviews. However, there is actual NO "coding", but more ...
Looking for Clinical Analyst & Coding Specialist- W2 Only (SC Resident) - 100% Remote
Columbia, SC · Remote
Title: Clinical Analyst & Coding Specialist- W2 Location: 100% Remote Duration: 12+ Months from ... An RN is required for the medical coding reviews. However, there is actual NO "coding", but more ...
Psychiatric Nurse Practitioner (PMHNP) - Telehealth
Edmund, SC · Remote
$84 - $115/hr
Flexible & Remote Telemedicine: Evidence-based approach to psychiatric care via telemedicine ... Active and clear APRN license * Licensed Nurse Practitioner - Certified in Psychiatric & Mental ...
Quick apply
Psychiatric Nurse Practitioner (PMHNP) - Telehealth
Edmund, SC · Remote
$84 - $115/hr
Flexible & Remote Telemedicine: Evidence-based approach to psychiatric care via telemedicine ... Active and clear APRN license * Licensed Nurse Practitioner - Certified in Psychiatric & Mental ...
IT Healthcare Consultant - Business Analyst (Clinical Analyst & Coding Specialist) - BA 26-05744
Columbia, SC · Remote
Fully Remote Job Type: Contract (12 Months) Job Overview: We are seeking an experienced IT Healthca ... Active, unrestricted Registered Nurse (RN) license * CPC (Certified Professional Coder) or CCS ...
Quick apply
IT Healthcare Consultant - Business Analyst (Clinical Analyst & Coding Specialist) - BA 26-05744
Columbia, SC · Remote
Fully Remote Job Type: Contract (12 Months) Job Overview: We are seeking an experienced IT Healthca ... Active, unrestricted Registered Nurse (RN) license * CPC (Certified Professional Coder) or CCS ...
Laboratory Technician (Clinical)
Columbia, SC · Remote
$40/hr
... Registered Nurses. Therapists: Physical Therapists, Occupational Therapists, Speech-Language ... Benefits This is a full-time or part-time REMOTE position. Choose which projects you want to work ...
Laboratory Technician (Clinical)
Columbia, SC · Remote
$40/hr
... Registered Nurses. Therapists: Physical Therapists, Occupational Therapists, Speech-Language ... Benefits This is a full-time or part-time REMOTE position. Choose which projects you want to work ...
... AIT), Registered Nurse (RN), or Certified Resident Assessment Coordinator (RAC-CT). Why ... Remote flexibility with regional travel to engage directly with providers and support on-site ...
... AIT), Registered Nurse (RN), or Certified Resident Assessment Coordinator (RAC-CT). Why ... Remote flexibility with regional travel to engage directly with providers and support on-site ...
Remote Rn Auditor information
See Lexington, SC salary details
$16.87 - $18.97
6% of jobs
$18.97 - $21.06
6% of jobs
$21.06 - $23.16
3% of jobs
$24.50 is the 25th percentile. Wages below this are outliers.
$23.16 - $25.25
15% of jobs
$25.25 - $27.35
17% of jobs
The median wage is $27.63 / hr.
$27.35 - $29.44
23% of jobs
$30.19 is the 75th percentile. Wages above this are outliers.
$29.44 - $31.54
15% of jobs
$31.54 - $33.63
8% of jobs
$33.63 - $35.73
0% of jobs
$35.73 - $37.82
0% of jobs
$37.82 - $39.92
7% of jobs
$16
$28
$39
How much do remote rn auditor jobs pay per hour?
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?
What are some common challenges faced by Remote RN Auditors, and how can they be effectively managed?
What is a Remote RN Auditor?
What is the difference between Remote Rn Auditor vs Remote Rn Reviewer?
| Aspect | Remote Rn Auditor | Remote Rn Reviewer |
|---|---|---|
| Certifications | RN license, auditing certifications (e.g., CHAP, RAC) | RN license, clinical review certifications |
| Work Environment | Healthcare organizations, insurance companies, auditing firms | Healthcare providers, insurance companies, utilization review |
| Primary Responsibilities | Auditing medical records for compliance, coding accuracy, and billing | Reviewing 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.
Full-time
Medical, Dental, Vision, Life, Retirement, PTO
Posted 5 days ago
Job description
Summary
Performs validation reviews of Diagnosis Related Groups (DRG), Ambulatory Procedure Codes (APC), and Never Events (serious, preventable medical errors) for all lines of business. Coordinates rate adjustments with claims areas. Provides monthly and quarterly reports outlining trends. Serves as a resource in resolving coding issues. Coordinates HIPAA and legal records requests for all areas of Healthcare Services and the Legal Department.
Description
Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but we've been part of the national landscape for more than seven decades, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina ... and much more. We are one of the nation's leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies, allowing us to build on various business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team!
Position Purpose: Performs validation reviews of Diagnosis Related Groups (DRG), Adaptive Predictive Coding (APC), and Never Events (inexcusable outcomes in a healthcare setting) for all lines of business. Coordinates rate adjustments with claims areas. Provides monthly and quarterly reports outlining trends. Serves as a resource in resolving coding issues. Coordinates HIPAA and legal records requests for all areas of Healthcare Services and the Legal Department.
Location: This is a remote position, Monday - Friday from 8:30am - 5pm.
What You'll Do:
Determines methodology to identify cases for validation review. Conducts validation reviews/coordinates rates adjustments with appropriate claims area. Creates monthly/quarterly reports to present to each line of business providing information on records review, outcomes, trends, and savings that directly impact medical costs and contracting rates.
Manages records retrieval, release, HIPAA compliance, and all aspects of document management.
Serves as expert resource on methodology and procedures for medical records and coding issues.
To Qualify for This Position, You'll Need the Following:
Required Education: Associates in a job-related field.
Degree Equivalency: 2 years job related work experience.
Required Work Experience: 3 years medical record management to include coding and validation review experience.
Skills and Abilities: Excellent verbal and written communication, organizational, customer service, and analytical or critical thinking skills. Good judgment. Ability to handle confidential or sensitive information with discretion. Extensive medical records and coding knowledge. Working knowledge of contract evaluations, claims processing and adjudication practices.
Required Licenses and Certificates: Registered health information administrator (RHIA) OR Registered health information technician (RHIT) OR Certified Professional Coder (CPC) OR Certified Inpatient Coder (CIC) or Certified Professional Medical Auditor (CPMA) OR, active, unrestricted RN licensure from the United States and in the state of hire, OR, active compact multi-state unrestricted RN license as defined by Nurse Licensure Compact (NLC).
Our Comprehensive Benefits Package Includes the Following:
We offer our employees great benefits and rewards. You will be eligible to participate in the benefits the first of the month following 28 days of employment.
Subsidized health plans, dental and vision coverage
401k retirement savings plan with company match
Life Insurance
Paid Time Off (PTO)
On-site cafeterias and fitness centers in major locations
Education Assistance
Service Recognition
National discounts to movies, theaters, zoos, theme parks and more
What We Can Do for You:
We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.
What To Expect Next:
After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements.
Equal Employment Opportunity Statement
BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilitiesand protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations.
We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company.
If you need special assistance or an accommodation while seeking employment, please email mycareer.help@bcbssc.comor call 800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.
We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here's moreinformation.
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