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Remote Rn Auditor Jobs in Woodbridge, VA (NOW HIRING)

Included Health

Urgent Care Nurse Practitioner

Washington, DC · Remote

$98K - $108K/yr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

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 ...

Sentara Healthcare

Nurse Case Manager-NOVA, VA

Manassas, VA · On-site +1

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Registered Nurse License (RN) - Nursing License - Compact/Multi-State License required. Experience ... For positions that are available as remote work, Sentara Health employs associates in the following ...

Sedgwick

RN Field Case Manager

Washington, DC · Remote

$88K - $112K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... remote work environment that allows face to face interaction with injured workers and medical ... RN licensure required. Valid driver's license required. High speed internet required. Employment ...

Sedgwick

RN Field Case Manager

Fairfax, VA · Remote

$79K - $101K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... remote work environment that allows face to face interaction with injured workers and medical ... RN licensure required. Valid driver's license required. High speed internet required. Employment ...

York Risk Services

RN Field Case Manager

Fairfax, VA · Remote

$79K - $101K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... remote work environment that allows face to face interaction with injured workers and medical ... RN licensure required. Valid driver's license required. High speed internet required. Employment ...

York Risk Services

RN Field Case Manager

Washington, DC · Remote

$88K - $112K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... remote work environment that allows face to face interaction with injured workers and medical ... RN licensure required. Valid driver's license required. High speed internet required. Employment ...

Maximus

Clinical Nurse Consultant

VA · On-site +1

  • Medical

  • Life

  • Retirement

  • PTO

This is a remote opportunity. The Consultant manages the end-to-end medical review process ... Preferred Skills and Qualifications: - Valid, active LPN or RN license. - Experience working with ...

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All JobsRn Auditor JobsRemote Rn Auditor JobsRemote Rn Auditor Jobs in Woodbridge, VA

Remote Rn Auditor information

See Woodbridge, VA salary details

$19

$32

$46

How much do remote rn auditor jobs pay per hour?

As of Aug 15, 2026, the average hourly pay for remote rn auditor in Woodbridge, VA is $32.63, according to ZipRecruiter salary data. Most workers in this role earn between $28.51 and $35.67 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

Integrated Care Manager/ Registered Nurse (RN) LTSS Waiver Members/Medicaid - Remote in NOVA (Fairfa

Sentara Healthcare

Alexandria, VA • On-site, Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 23 days ago

Sentara Health rating

6.7

Company rating: 6.7 out of 10

Based on 412 frontline employees who took The Breakroom Quiz

530th of 887 rated healthcare providers

Job description

City/State
Fairfax, VA
Work Shift
First (Days)
Overview:
Sentara Health Plans is hiring an Integrated Care Manager/ Registered Nurse (RN) LTSS Waiver Members/Medicaid - Remote in NOVA (Fairfax, Springfield and Alexandria, VA) and the surrounding areas!
Status: Full-time, permanent position (40 hours)
Standard working hours: 8 am to 5 pm EST, M-F
The position requires in person/face-to-face assessments with remote/home office for the Long-Term Services and Supports (LTSS) Waiver Members/Medicaid in Northern Virginia (Fairfax, Springfield, and Alexandria, VA), and the surrounding areas! May travel up to 1 hour max.
Location: Candidate must reside in Northern Virginia (Fairfax, Springfield, and Alexandria, VA), and the surrounding areas
Job responsibilities:
  • Responsible for case management services within the scope of licensure; develops, monitors, evaluates, and revises the member's care plan to meet the member's needs, with the goal of optimizing member health care across the care continuum
  • Performs telephonic or face-to-face clinical assessments for the identification, evaluation, coordination and management of member's needs, including physical and behavioral health, social services and long-term services
  • Identifies members for high-risk complications and coordinates care in conjunction with the member and health care team
  • Manages chronic illnesses, co-morbidities, and/or disabilities ensuring cost effective and efficient utilization of health benefits; conducts gap in care management for quality programs
  • Assists with the implementation of member care plans by facilitating authorizations/referrals within benefits structure or extra-contractual arrangements, as permissible
  • Interfaces with Medical Directors, Physician Advisors and/or Inter-Disciplinary Teams on care management treatment plans
  • Presents cases at case conferences for multidisciplinary focus. Ensures compliance with regulatory, accrediting and company policies and procedures
  • May assist in problem solving with provider, claims or service issues.

Education:
  • BLD - Bachelor's Level Degree in Nursing preferred

Certification/Licensure:
  • Registered Nurse (RN) License (Compact or Virginia) REQUIRED

Experience:
  • 3 years experience in Nursing REQUIRED
  • Managed Care/ Health Plan/ Health Insurance experience highly preferred
  • Case Management experience preferred
  • Long-Term Services and Supports (LTSS) waiver and Home Health experience preferred
  • Behavioral Health experience is secondary

Sentara Health Plans provides health plan coverage to close to one million members in Virginia. We offer a full suite of commercial products, including employee-owned and employer-sponsored plans, as well as Individual & Family Health Plans, Employee Assistance Programs, and plans serving Medicare and Medicaid enrollees.
Our quality provider network features a robust provider network, including specialists, primary care physicians and hospitals.
We offer programs to support members with chronic illnesses, customized wellness programs, and integrated clinical and behavioral health services-all to help our members improve their health.
Our success is supported by a family-friendly culture that encourages community involvement and creates unlimited opportunities for development and growth.
Be a part of an excellent healthcare organization that cares about our People, Quality, Patient Safety, Service, and Integrity. Join a team that has a mission to improve health every day and a vision to be the healthcare choice of the communities that we serve!
To apply, please go to www.sentaracareers.com and use the following as your Keyword Search: JR-103241
Talroo - Health Plan
Keywords: Medicaid, Managed Care, Health Plan, Health Insurance, MCO, Integrated Case Manager, Registered Nurse, RN, Nursing, Fairfax, Springfield, and Alexandria, VA, Northern Virginia, NOVA, Long-Term Services and Supports (LTSS), Waiver, Home Health
Benefits: Caring For Your Family and Your Career
• Medical, Dental, Vision plans
• Adoption, Fertility and Surrogacy Reimbursement up to 10,000
• Paid Time Off and Sick Leave
• Paid Parental & Family Caregiver Leave
• Emergency Backup Care
• Long-Term, Short-Term Disability, and Critical Illness plans
• Life Insurance
• 401k/403B with Employer Match
• Tuition Assistance - 5,250/year and discounted educational opportunities through Guild Education
• Student Debt Pay Down - 10,000
• Reimbursement for certifications and free access to complete CEUs and professional development
• Pet Insurance
• Legal Resources Plan
• Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.
Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.
In support of our mission "to improve health every day," this is a tobacco-free environment.
For positions that are available as remote work, Sentara Health employs associates in the following states:
Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.

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