Active, non-restricted Registered Nurse (RN) license . * Strong computer proficiency with excellent written communication skills. * Demonstrated research and analytical skills. Preferred ...
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Active, non-restricted Registered Nurse (RN) license . * Strong computer proficiency with excellent written communication skills. * Demonstrated research and analytical skills. Preferred ...
Quick apply
Active, non-restricted Registered Nurse (RN) license . * Strong computer proficiency with excellent written communication skills. * Demonstrated research and analytical skills. Preferred ...
Active, non-restricted Registered Nurse (RN) license . * Strong computer proficiency with excellent written communication skills. * Demonstrated research and analytical skills. Preferred ...
Quick apply
Active, non-restricted Registered Nurse (RN) license . * Strong computer proficiency with excellent written communication skills. * Demonstrated research and analytical skills. Preferred ...
Baltimore, MD · Remote
$46 - $51/hr
Qualification And Education: * RN - Registered Nurse - State Licensure And/or Compact State Licensure Upon Hire. * LPN - Licensed Practical Nurse - State Licensure. * CNS-Clinical Nurse Specialist ...
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Baltimore, MD · Remote
$46 - $51/hr
Qualification And Education: * RN - Registered Nurse - State Licensure And/or Compact State Licensure Upon Hire. * LPN - Licensed Practical Nurse - State Licensure. * CNS-Clinical Nurse Specialist ...
Linthicum, MD · On-site +1
$406K/yr
... auditors to ensure that uncompensated patient revenues resulting from audits of patient service ... All registered nurses working within UMMS shall follow the guidelines for professional practice ...
New
Linthicum, MD · On-site +1
$406K/yr
... auditors to ensure that uncompensated patient revenues resulting from audits of patient service ... All registered nurses working within UMMS shall follow the guidelines for professional practice ...
New
Nottingham, MD · Remote
$63K - $95K/yr
This is a remote role. California RN license is required for this role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Provide medical case management to individuals through coordination with the patient ...
Nottingham, MD · Remote
$63K - $95K/yr
This is a remote role. California RN license is required for this role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Provide medical case management to individuals through coordination with the patient ...
Nottingham, MD · Remote
$63K - $95K/yr
This is a remote role. California RN license is required for this role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Provide medical case management to individuals through coordination with the patient ...
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Nottingham, MD · Remote
$63K - $95K/yr
This is a remote role. California RN license is required for this role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Provide medical case management to individuals through coordination with the patient ...
Licenses/Certifications: * RN - Registered Nurse - State Licensure And/or Compact State Licensure Upon Hire Required. * CCM - Certified Case Manager Upon Hire Preferred. * LNCC - Legal Nurse ...
Licenses/Certifications: * RN - Registered Nurse - State Licensure And/or Compact State Licensure Upon Hire Required. * CCM - Certified Case Manager Upon Hire Preferred. * LNCC - Legal Nurse ...
Columbia, MD · Remote
$125K - $145K/yr
Be available for remote clinical support and video consultations as needed Ideal Background * Nurse ... Previous infusion services experience required * 10+ years of RN and/or NP experience preferred ...
Columbia, MD · Remote
$125K - $145K/yr
Be available for remote clinical support and video consultations as needed Ideal Background * Nurse ... Previous infusion services experience required * 10+ years of RN and/or NP experience preferred ...
We are seeking a dynamic, self-motivated Registered Nurse who is passionate about patient-centered ... remote patient monitoring, virtual platforms and telephone outreach * Identify changes in patient ...
We are seeking a dynamic, self-motivated Registered Nurse who is passionate about patient-centered ... remote patient monitoring, virtual platforms and telephone outreach * Identify changes in patient ...
Nottingham, MD · On-site +1
$120K - $155K/yr
This position is a fully remote role and requires working hours in EST or CST. An active and clear RN and APRN or Physician Assistant license in GA, PA, and/or OH is required at time of hire. A bit ...
Nottingham, MD · On-site +1
$120K - $155K/yr
This position is a fully remote role and requires working hours in EST or CST. An active and clear RN and APRN or Physician Assistant license in GA, PA, and/or OH is required at time of hire. A bit ...
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years ...
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Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years ...
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years ...
Quick apply
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years ...
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years ...
Quick apply
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years ...
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years ...
Quick apply
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years ...
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years ...
Quick apply
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years ...
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years ...
Quick apply
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years ...
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years ...
Quick apply
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years ...
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years ...
Quick apply
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years ...
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years ...
Quick apply
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years ...
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years ...
Quick apply
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years ...
$18.88 - $21.23
6% of jobs
$21.23 - $23.57
6% of jobs
$23.57 - $25.92
3% of jobs
$27.43 is the 25th percentile. Wages below this are outliers.
$25.92 - $28.26
15% of jobs
$28.26 - $30.61
17% of jobs
The median wage is $30.93 / hr.
$30.61 - $32.95
23% of jobs
$33.79 is the 75th percentile. Wages above this are outliers.
$32.95 - $35.30
15% of jobs
$35.30 - $37.64
8% of jobs
$37.64 - $39.99
0% of jobs
$39.99 - $42.33
0% of jobs
$42.33 - $44.68
7% of jobs
$18
$31
$44
| 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.
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.
Baltimore, MD • Remote
Full-time
Re-posted 3 days ago
Job Responsibilities
Review beneficiary, provider, and/or pharmacy cases for potential overpayment, fraud, waste, and abuse.
Conduct desk reviews in alignment with applicable contract requirements to identify potential fraud or overpayment.
Prepare detailed case summaries and provide results to investigators to support the investigative process.
Perform case-specific or plan-specific data entry and reporting to ensure accuracy and compliance.
Required Qualifications
Active, non-restricted Registered Nurse (RN) license.
Strong computer proficiency with excellent written communication skills.
Demonstrated research and analytical skills.
Preferred Qualifications
Coding certification (e.g., CPC, CCS, or equivalent).
Familiarity with Medicaid and Medicare regulations.
Experience with medical chart review.
Broad clinical background; experience in Hospice, Home Health, or Skilled Nursing Facility (SNF) review highly beneficial.