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Remote Rn Auditor Jobs in Silver Spring, MD (NOW HIRING)

CareFirst

Care Manager (Remote)

Baltimore, MD · Remote

CCM/ACM or other RN Board Certified certification in case management. * Previous experience with Medicare and/or Medicare Advantage patient populations with multiple co-morbidities, complex needs ...

Avail Health

RN Care Manager, Care Transitions

Rockville, MD · On-site +1

$94K - $115K/yr

The RN Care Manager leads the medical track of that program - serving as the primary clinical point ... Hybrid - primarily remote with in-person visits when clinically indicated Schedule: Monday-Friday ...

Grand Rounds

Urgent Care Nurse Practitioner

Washington, DC · Remote

$123K/yr

This role requires an active RN compact license and licensure in multiple states. Ideal candidates ... Remote-first culture 401(k) savings plan through Fidelity Comprehensive medical, vision, and dental ...

CareFirst

Clinical Navigator (Remote)

Baltimore, MD · Remote

The Post- Acute Care Clinical Navigator (RN) manages the timely and smooth transition from inpatient care to home or other levels of care utilizing experience and skills in both care management and ...

CINQCARE

Transition of Care Nurse

Washington, DC · Remote

Maintain active RN licensure and adhere to professional nursing standards and scope of practice ... Experience providing telephonic or remote patient support preferred. * Familiarity with post-acute ...

New

CareFirst

Care Manager (Remote)

Baltimore, MD · Remote

Licenses/Certifications : * RN - Registered Nurse - State Licensure And/or Compact State Licensure RN- Registered Nurse in MD, VA or Washington, DC Upon Hire Required * Must have CCM or other RN ...

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All JobsRemote Rn Auditor JobsRemote Rn Auditor Jobs in Silver Spring, MD

Remote Rn Auditor information

See Silver Spring, MD salary details

$20

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$48

How much do remote rn auditor jobs pay per hour?

As of Jun 19, 2026, the average hourly pay for remote rn auditor in Silver Spring, MD is $34.00, according to ZipRecruiter salary data. Most workers in this role earn between $29.71 and $37.16 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
Registered Nurse Case Manager, Care Delivery

Registered Nurse Case Manager, Care Delivery

University of Maryland Medical System

Linthicum Heights, MD • Remote

Full-time

Posted 29 days ago

Job description

Job Requirements

Position Summary

The RN Care Manager is responsible for applying the nursing process, evidence-based practice, and care management principles to support heart failure patients enrolled in the Heart Failure Bridge Clinic. This role focuses on outreaching to high-risk patients, coordinating care across settings, supporting medication and symptom management, and fostering patient engagement and self-management.

The RN Care Manager collaborates closely with physicians, pharmacists, social workers, care coordinators, and administrative staff to ensure seamless transitions of care and to address medical, behavioral, and social needs that influence health outcomes.

Principal Responsibilities and Tasks

Clinical Assessment & Critical Thinking

Apply the nursing process and evidence-based standards to assess patient needs and guide care planning.

Evaluate clinical, psychosocial, and environmental factors impacting heart failure management and recovery.

Identify patients who may benefit from telephonic and virtual outreach and initiate care management interventions.

Participate in remote patient monitoring and support self-management skills.

Population Health & Care Management

Analyze utilization patterns including inpatient admissions, ED visits, readmissions, and high-cost utilization.

Develop population-based strategies to improve quality, reduce avoidable utilization, and enhance patient engagement.

Manage active cases based on acuity and intensity, ensuring timely follow-up and escalation when needed.

Transitional Care & Coordination

Track and support transitions of care, ensuring "warm handoffs" between hospitals, emergency departments, clinics, and community settings.

Coordinate follow-up appointments, diagnostic testing, and referrals to pharmacy, behavioral health, and specialty services.

Facilitate communication among all members of the care team to minimize fragmentation and ensure continuity.

Patient Engagement, Coaching & Education

Establish collaborative partnerships with patients and caregivers to support self-management, lifestyle changes, and adherence to treatment plans.

Educate patients on heart failure management, medication adherence, symptom monitoring, and available community resources.

Advocate for patients and help them navigate medical, behavioral, and social service systems.

Social Determinants of Health

Screen for SDOH barriers and connect patients to community resources addressing transportation, food insecurity, housing, medication access, and more.

Consult with external agencies to coordinate support services.

Documentation, Compliance & Quality

Document all assessments, interventions, and communications in the EMR and care management platforms.

Participate in chart audits, quality reviews, and program evaluation activities.

Ensure compliance with federal and state regulations, case management standards, and HIPAA requirements.

Report critical incidents and quality-of-care concerns promptly.

Team Leadership & Collaboration

Work collaboratively with physicians, pharmacists, social workers, care coordinators, and administrative leaders to design and implement care management protocols.

Provide mentorship and clinical guidance to chronic disease care coordinators and other team members.

Delegate appropriate tasks to support staff while maintaining oversight of patient outcomes.

Participate in special projects and contribute to program development.


Work Experience

Education and Experience

Licensure as a Registered Nurse in the state of Maryland, or eligible to practice due to Compact state agreements outlined through the MD Board of Nursing, is required; BSN preferred.

3 to 5 years of care coordination experience and/or experience working in an outpatient ambulatory setting

Experience with educating patients and patient goal setting (essential)

Case Management Certification (preferred)

Experience in a manage care information environment (preferred)

Preferred experience would include knowledge of quality improvement processes (LEAN or PDSA); practice re-design work such as patient centered medical home and Joint Commission and National Committee for Quality Assurance (NCQA) accreditations.

Knowledge, Skills and Abilities

Knowledge and experience with managing and overseeing the comprehensive assessment, planning, implementation and overall evaluation of individual patient needs

Proficient analytical, organization, and problem-solving skills to identify opportunities, to implement efficient work processes as it relates to case management

Proficient documentation skills to maintain client records

Ability to work effectively in a stressful work environment and handle confidential issues with integrity and discretion

Critical thinking skills to analyze and solve problems

Strong problem management strategies and issue resolution skills

Excellent interpersonal, verbal, and written communication skills

Strong organization skills, detail oriented, and knowledgeable Ability to work independently and effectively in a fast pace environment. Ability to work productively in a stressful environment and effectively handle multiple projects and changing priorities.

Ability to effectively present information and respond to questions from families, members, providers, and clients, as well as the ability to relate effectively to upper management

Ability to work independently, handle multiple assignments, establish priorities, and demonstrate high level time management skills Understands benefit/payer systems and reimbursement structures for patients.

Strong clinical knowledge of broad range of medical practice settings and healthcare delivery systems

Thorough and solid knowledge of health care and managed care delivery systems. This includes standards of medical practice, insurance benefits structure, and the utilization and case management process.

Knowledge of state and federal laws and resources

Proficiency in Microsoft Office including Outlook, Word, Excel and PowerPoint; knowledge of or the ability to learn care management/EMR software (e.g., Epic) and other software in order to perform job duties


Employment Type: FULL_TIME

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