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Remote Rn Auditor Jobs in Lexington, SC (NOW HIRING)

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 ...

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 ...

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Remote Rn Auditor information

See Lexington, SC salary details

$16

$28

$39

How much do remote rn auditor jobs pay per hour?

As of May 29, 2026, the average hourly pay for remote rn auditor in Lexington, SC is $28.24, according to ZipRecruiter salary data. Most workers in this role earn between $24.71 and $30.87 per hour, depending on experience, location, and employer.

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.

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.

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 are popular job titles related to Remote Rn Auditor jobs in Lexington, SC? For Remote Rn Auditor jobs in Lexington, SC, the most frequently searched job titles are:
What job categories do people searching Remote Rn Auditor jobs in Lexington, SC look for? The top searched job categories for Remote Rn Auditor jobs in Lexington, SC are:
What cities near Lexington, SC are hiring for Remote Rn Auditor jobs? Cities near Lexington, SC with the most Remote Rn Auditor job openings:

Quality Medical Auditor - Inpatient Coding

Ourhrconnect

Columbia, SC • Remote

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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