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Remote Rn Auditor Jobs in Phoenix, AZ (NOW HIRING)

Oscar Health

Sr. Quality of Care Review Nurse

Tempe, AZ · Remote

$83K - $109K/yr

This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas ... Licensed Registered Nurse with active, unrestricted license in state of residence and willingness ...

TEEMA Group

Clinical Quality Review Nurse

Phoenix, AZ · Remote

$41 - $44/hr

CLINICAL QUALITY REVIEWER (RN or LCSW) Location: USA- Remote in approved states Overview: TEEMA is partnering with a leading organization supporting a large-scale federal healthcare program to ...

Renalogic

Bilingual Clinical Nurse Coach (RN)

Phoenix, AZ · On-site +1

$78K - $100K/yr

US; remote with minimal travel Schedule: Mon - Fri; at least two late shifts per week (1:00 pm - 10 ... Must have an RN license in good standing and be willing to obtain licensure in other states. * A ...

Renalogic

Bilingual Clinical Nurse Coach (RN)

Phoenix, AZ · Remote

$78K - $100K/yr

US; remote with minimal travel Schedule: Mon - Fri; at least two late shifts per week (1:00 pm - 10 ... Must have an RN license in good standing and be willing to obtain licensure in other states. * A ...

Renalogic

Bilingual Clinical Nurse Coach (RN)

Phoenix, AZ · On-site +1

$80K - $100K/yr

US; remote with minimal travel Schedule: Monday - Friday, with three late shifts (11 am - 8 pm PST ... Must have an RN license in good standing and be willing to obtain licensure in other states. * A ...

Renalogic

Bilingual Clinical Nurse Coach (RN)

Phoenix, AZ · Remote

$80K - $100K/yr

US; remote with minimal travel Schedule: Monday - Friday, with three late shifts (11 am - 8 pm PST ... Must have an RN license in good standing and be willing to obtain licensure in other states. * A ...

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All JobsRn Auditor JobsRemote Rn Auditor JobsRemote Rn Auditor Jobs in Phoenix, AZ

Remote Rn Auditor information

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How much do remote rn auditor jobs pay per hour?

As of Aug 10, 2026, the average hourly pay for remote rn auditor in Phoenix, AZ is $31.81, according to ZipRecruiter salary data. Most workers in this role earn between $27.79 and $34.76 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.

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.

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 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.

Can you work remotely as a remote RN auditor?

Yes, remote RN auditors can often work from home, as the role primarily involves reviewing medical records and documentation electronically. Strong computer skills, familiarity with auditing software, and relevant nursing licensure are typically required, and employers may set specific remote work policies or schedules.
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Remote Rn Auditor jobs near you
Infographic showing various Remote Rn Auditor job openings in Phoenix, AZ as of August 2026, with employment types broken down into 3% As Needed, 53% Full Time, 15% Part Time, and 29% Contract. Highlights an 99% Physical, and 1% Remote job distribution, with an average salary of $66,155 per year, or $31.8 per hour.

Integrated Care Manager (Maternal Health) - Remote

Blue Cross Blue Shield of Arizona

Phoenix, AZ • On-site, Remote

Full-time

Medical

Re-posted 24 days ago

Blue Cross Blue Shield Of Arizona rating

5.9

Company rating: 5.9 out of 10

Based on 13 frontline employees who took The Breakroom Quiz

286th of 304 rated insurance

Job description

Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. AZ Blue offers a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions.
At AZ Blue, we have a hybrid workforce strategy, called Workability, that offers flexibility with how and where employees work. Our positions are classified as hybrid, onsite or remote. While the majority of our employees are hybrid, the following classifications drive our current minimum onsite requirements:
  • Hybrid People Leaders: must reside in AZ, required to be onsite at least twice per week
  • Hybrid Individual Contributors: must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per week
  • Hybrid 2 (Operational Roles such as but not limited to: Customer Service, Claims Processors, and Correspondence positions): must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per month
  • Onsite: daily onsite requirement based on the essential functions of the job
  • Remote: not held to onsite requirements, however, leadership can request presence onsite for business reasons including but not limited to staff meetings, one-on-ones, training, and team building

Please note that onsite requirements may change in the future, based on business need, and job responsibilities. Most employees should expect onsite requirements and at a minimum of once per week.
This position is remote within the state of AZ only. This remote work opportunity requires residency, and work to be performed, within the State of Arizona.
PURPOSE OF THE JOB
Responsible for promoting continuity of care through a collaborative process that assesses, plans, implements, coordinates, monitors, and evaluates care options and services available to members through their benefit plan that meet the individuals' health care needs while promoting quality, cost effective outcomes. This job description is primary for case management functions but can assist with utilization management if a business need arises.
REQUIRED QUALIFICATIONS
Required Work Experience
  • 2 year(s) of experience in full-time equivalent of direct clinical care to the consumer

Required Education
  • Associate's Degree in general field of study or Post High School Nursing Diploma or Master's Degree in a behavioral health field of study (i.e., MSW, MA, MS, M.Ed.), Ph.D. or Psy.D

Required Licenses
  • Active, current, and unrestricted license to practice in the State of Arizona (or an endorsement to work in Arizona) as a behavioral health professional such as LCSW, LPC, LISAC LMFT, or licensed psychologist (Psy.D. or Ph.D.), OR an active, current, and unrestricted license to practice nursing in either the State of Arizona or another state in the United States recognized by the Nursing Licensure Compact (NLC) as an RN.

Required Certifications
  • Within 4 years of hire as a Care Manager employee must hold a certification in case management from the following certifications; Certified Case Manager (CCM), Certified Disability Management Specialist (CDMS), Case Management Administrator, Certified (CMAC), Case Management Certified (CMC), Certified Rehabilitation Counselor (CRC), Certified Registered Rehabilitation Counselor (CRRC), Certified Occupational Health Nurse (COHN), Registered Nurse Case Manager (RN, C), or Registered Nurse Case Manager (RN,BC).

PREFERRED QUALIFICATIONS
Preferred Work Experience
  • 3 year(s) of experience in full-time equivalent of direct clinical care to the consumer (managed care CM experience preferred)
  • 1-2 year (s) of experience working in a managed care organization

Preferred Education
  • Bachelor's Degree in Nursing or Health and Human Services related field of study

Preferred Licenses
  • N/A

Preferred Certifications
  • Active and current certification in case management from the following certifications; Certified Case Manager (CCM), Certified Disability Management Specialist (CDMS), Case Management Administrator, Certified (CMAC), Case Management Certified (CMC), Certified Rehabilitation Counselor (CRC), Certified Registered Rehabilitation Counselor (CRRC), Certified Occupational Health Nurse (COHN), Registered Nurse Case Manager (RN, C), or Registered Nurse Case Manager (RN,BC).

ESSENTIAL JOB FUNCTIONS AND RESPONSIBILITIES
  • Assess and collect data related to the member from all care settings. Interview and collaborate with case-related providers, member and family to implement the care plan.
  • Answer a diverse and high volume of health insurance related customer calls on a daily basis.
  • Explain to customers a variety of information concerning the organization's services, including but not limited to, contract benefits, changes in coverage, eligibility, claims, BCBSAZ programs, provider networks, etc.
  • Analyze medical records and apply medical necessity criteria and benefit plan requirements to determine the appropriateness of benefit requests.
  • Present status reports on all cases to the manager/supervisor and, when indicated, to the medical director.
  • Consult and coordinate with various internal departments, external plans, providers, businesses, and government agencies to obtain information and ensure resolution of customer inquiries.
  • Meet quality, quantity and timeliness standards to achieve individual and department performance goals as defined within the department guidelines.
  • Maintain all standards in consideration of state, federal, BCBSAZ, URAC, and other accreditation requirements.
  • Maintain complete and accurate records per department policy.
  • Demonstrate ability to apply plan policies and procedures effectively.
  • When indicated to assist with team/project functions:
    • Collaborate with team to distribute workload/work tasks;
    • Monitor and report team tasks;
    • Communicate team issues and opportunities for improvement to supervisor/manager;
    • Support/mentor team members.
  • Participate in continuing education and current development in the field of medicine, behavioral health and managed care at least annually.

  • The position requires a full-time work schedule. Full-time is defined as working at least 40 hours per week, plus any additional hours as requested or as needed to meet business requirements.
  • Perform all other duties as assigned.

REQUIRED COMPETENCIES
Required Job Skills
  • Intermediate PC proficiency
  • Intermediate skill in use of office equipment, including copiers, fax machines, scanner and telephones
  • Intermediate skill in word processing, spreadsheet, and database software

Required Professional Competencies
  • Maintain confidentiality and privacy
  • Advanced and current clinical knowledge
  • Practice interpersonal and active listening skills to achieve customer satisfaction
  • Interpret and translate policies, procedures, programs, and guidelines
  • Capable of investigative and analytical research
  • Demonstrated organizational skills with the ability to priortize tasks and work with multiple priorities
  • Follow and accept instruction and direction
  • Establish and maintain working relationships in a collaborative team environment
  • Apply independent and sound judgment with good problem solving skills
  • Navigate, gather, input, and maintain data records in multiple system applications

Required Leadership Experience and Competencies
  • Conflict Resolution
  • Represent BCBSAZ in the community

PREFERRED COMPETENCIES
Preferred Job Skills
  • Advanced PC proficiency
  • Knowledge of CPT 2018 and ICD-10 coding

Preferred Professional Competencies
  • Knowledge of managed care, utilization management, and quality management
  • Working knowledge of McKesson InterQual, MCG, ASAM, or other nationally recognized criteria
  • Knowledge of a wide range of matters pertaining to the organizations services and operations
  • Knowledge of health and/or patient education and behavior change techniques

Preferred Leadership Experience and Competencies
  • N/A

Our Commitment
AZ Blue does not discriminate in hiring or employment on the basis of race, ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status or any other protected group.
Thank you for your interest in Blue Cross Blue Shield of Arizona. For more information on our company, see azblue.com. If interested in this position, please apply.

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