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Remote Rn Auditor Jobs in Springfield, IL (NOW HIRING)

Humana

Manager, Care Management

Springfield, IL · Remote

Active Registered Nurse (RN) license or Social Work (SW) license * 5+ years of professional ... This is a remote position that requires travel. * Travel: 50 - 75% field-based interactions ...

Humana

Manager, Care Management

Springfield, IL · Remote

Active Registered Nurse (RN) license or Social Work (SW) license * 5+ years of professional ... This is a remote position that requires travel. * Travel: 50 - 75% field-based interactions ...

Humana

Manager, Care Management

Springfield, IL · Remote

Active Registered Nurse (RN) license or Social Work (SW) license * 5+ years of professional ... This is a remote position that requires travel. * Travel: 50 - 75% field-based interactions ...

All JobsRn Auditor JobsRemote Rn Auditor JobsRemote Rn Auditor Jobs in Springfield, IL

Remote Rn Auditor information

See Springfield, IL salary details

$19

$32

$46

How much do remote rn auditor jobs pay per hour?

As of Jul 16, 2026, the average hourly pay for remote rn auditor in Springfield, IL is $32.70, according to ZipRecruiter salary data. Most workers in this role earn between $28.61 and $35.72 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.

Can you work remotely as an auditor?

Remote Rn Auditor positions are available and typically involve reviewing healthcare documentation and compliance from a home office. These roles often require strong computer skills, familiarity with auditing software, and adherence to confidentiality standards, making remote work feasible for qualified professionals.

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 increase earnings by gaining specialized certifications, such as in coding or compliance, and working for multiple clients or agencies to maximize income. Building a strong reputation and leveraging telehealth platforms can also lead to higher-paying opportunities, but reaching $300,000 annually typically requires extensive experience, advanced skills, and possibly additional roles or consulting work.

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 highest paying remote nurse job?

The highest paying remote nurse jobs typically include roles such as remote nurse anesthetists, nurse practitioners, and clinical nurse specialists, with salaries often exceeding $100,000 annually. These positions usually require advanced certifications, specialized skills, and experience in telehealth or case management environments.

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 you become a nurse auditor?

To become a nurse auditor, you typically need a registered nurse (RN) license and experience in healthcare or medical billing. Many employers prefer candidates with knowledge of insurance claims, coding, and auditing procedures, and some may require certification such as the Certified Professional Medical Auditor (CPMA).
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Remote Rn Auditor jobs near you
Coder Quality Auditor

Coder Quality Auditor

Ensemble Health Partners

Springfield, IL • Remote

$57K - $99K/yr

Full-time

Posted 2 days ago

New

Ensemble Health Partners rating

6.5

Company rating: 6.5 out of 10

Based on 239 frontline employees who took The Breakroom Quiz

140th of 148 rated financial services

Job description

CAREER OPPORTUNITY OFFERING:

  • Bonus Incentives
  • Paid Certifications
  • Tuition Reimbursement
  • Comprehensive Benefits
  • Career Advancement
  • This position pays between $57,400 to $99,000 annually based on experience

The Coder Quality Auditor conducts monthly and quarterly quality assessments of individual codes. Provides guidance and education to coding associates and leaders on established coding guidelines and procedures. Performs additional quality assurance follow-up reviews to assess comprehension of education and training efforts. Serves as a subject matter expert for professional fee coding for all involved personnel; ensures that information is accurate and current, meeting professional coding standards and following CMS/AMA guidelines.  Candidate should possess the ability to code and a clear understanding of the coding principles and guidelines for multiple specialties. 

Job Responsibilities:

  • Quality Review - Monitors and audits inpatient and outpatient accounts across the system, looking at physician coding for both inpatient and outpatient accounts. Performs initial baselines as well as quarterly performance quality assurance reviews to assess coders’ comprehension and further assess ongoing education. Also assists in special project audits, as assigned. 
  • Educating - Assesses the educational needs of coding staff based on individual coder audit results and overall trends. Creates presentations, develops learning material, handbook and other educational materials. 
  • Edits/Denials/Coding - Assists operational coding team with initial coding, edits, and denials and appeals on an as needed basis.
  • Training - Assists with training new and existing staff. Develops all training materials and coding aids for both formal training and use by coders in daily work. Identifies coders to be cross-trained and suggests areas for training improvement. Assists in the implementation and administration of effective systems, processes, and procedures. 
  • Resource - Serves as a technical resource for all involved personnel; ensures that information is accurate and current, meeting AMA, CMS, and professional coding standards. Performs miscellaneous job-related duties as assigned.
  • Reporting - Provides reports of audit findings to coding management, individual coders and leadership as needed/requested along with providers that are contracted/employed and outlined in the client SOW.  Assists with the creation of various documents and reports as requested. Immediately provides reports related to compliance risks when requested. 

Experience We Love:

  • 5+ years of coding experience. 

  • 3+ years of auditing experience. 

  • Proficiency in multiple EMR’s, encoders, and the Microsoft Office suite. 

  • Educated in HIPAA regulations; must maintain strict confidentiality of patient and client information. 

  • Consistently achieves quality and productivity standards. 

  • Ability to organize and complete work in a timely manner. 

  • Ability to read, write and effectively communicate in English. 

  • Ability to understand medical/surgical terminology. 

  • Above average written and verbal communication skills. 

  • Must be inquisitive and demonstrate openness to innovation including AI to explore better processes and ways to alleviate friction and improve patient and client experiences. 

  • This is a remote position; however, candidates must be willing and able to travel to and work onsite at client, temporary, or corporate office locations as business needs require.

Minimum Education:

  • Associates degree or equivalent experience 

Required Certifications:

Candidates must have and keep current at least one of the following professional certifications (CPC, CPMA or CCS Preferred):

  • CPC (Certified Professional Coder)
  • CCS-P (Certified Coding Specialist-Phys Based)
  • CCS (Certified Coding Specialist)
  • CMPA (Certified Professional Medical Auditor)
  • RHIA (Registered Health Information Administrator)
  • RHIT (Registered Health Information Technician)

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