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Remote Rn Coder Jobs in Los Alamitos, CA (NOW HIRING)

Zócalo Health

RN Case Manager

Los Angeles, CA · Remote

$85K/yr

RN Case Manager Remote (Full Time) Compensation: $85,000 About Us Zócalo Health is a tech-enabled, community-oriented primary care organization serving people who have historically been underserved ...

Molina Healthcare

Care Manager, LTSS (RN)

Long Beach, CA · On-site +1

$26.41 - $51.49/hr

***Remote with travel throughout Dane County, WI for member visits*** Job Summary Provides support for ... RNs may conduct medication reconciliation as needed. • 25-40% estimated local travel may be ...

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How much do remote rn coder jobs pay per hour?

As of Jul 11, 2026, the average hourly pay for remote rn coder in Los Alamitos, CA is $22.59, according to ZipRecruiter salary data. Most workers in this role earn between $18.94 and $23.99 per hour, depending on experience, location, and employer.

What Are Jobs for an RN Coder Who Works Remotely?

A remote RN coder works with medical codes that healthcare providers use for patient records, billing, insurance, and quality assurance. In this career, your duties include using the internet to access patient records and reports. You then assign codes for each diagnosis and procedure that the patient receives in the medical facility’s database. You work with clinical coding systems like the International Classification of Diseases (ICD) and Current Procedural Terminology (CPT) codes. In addition to applying codes, your responsibilities as an RN coder sometimes include auditing the work of other coders to ensure accuracy.

What are the key skills and qualifications needed to thrive as a Remote RN Coder, and why are they important?

To thrive as a Remote RN Coder, you need a current RN license, in-depth clinical knowledge, and expertise in medical coding and documentation standards. Familiarity with coding software (such as 3M or Epic), knowledge of ICD-10-CM/PCS and CPT coding systems, and certifications like CCS or CPC are commonly required. Strong attention to detail, self-motivation, and effective communication are critical soft skills for accuracy and collaboration in a remote environment. These skills ensure precise coding, compliance with healthcare regulations, and efficient remote workflow management.

What are some common challenges faced by Remote RN Coders, and how can they be addressed?

Remote RN Coders often encounter challenges such as staying updated with changing coding regulations, maintaining accuracy while working independently, and ensuring secure handling of patient data. To address these, it's important to participate in regular training sessions, leverage secure coding platforms, and establish clear communication with team members and supervisors. Effective time management and a dedicated home office setup also help maintain productivity and focus in a remote environment.

What is the difference between Remote Rn Coder vs Remote Medical Biller?

AspectRemote Rn CoderRemote Medical Biller
CredentialsCertification in coding (e.g., CPC, CCS)Certification in billing (e.g., Certified Professional Biller)
Work EnvironmentHealthcare facilities, insurance companies, remote coding firmsMedical offices, billing companies, insurance companies
Industry UsageUsed primarily for coding diagnoses and procedures for reimbursementUsed for submitting claims and managing payments

Remote Rn Coders focus on translating medical records into standardized codes for billing and reimbursement, requiring coding certifications. Remote Medical Billers handle the submission of claims and follow-up on payments. While both roles work remotely within healthcare, their core responsibilities differ, with Rn Coders concentrating on coding accuracy and Medical Billers on claims processing.

What is a Remote RN Coder?

A Remote RN Coder is a registered nurse who specializes in reviewing clinical documentation and assigning medical codes to diagnoses and procedures for billing and insurance purposes, all while working remotely. These professionals use their clinical knowledge to ensure accurate coding, which is essential for healthcare reimbursement and compliance. Remote RN Coders often work from home using secure access to patient records and coding software, making this role ideal for nurses seeking flexible work arrangements.
More about Remote Rn Coder jobs
What cities near Los Alamitos, CA are hiring for Remote Rn Coder jobs? Cities near Los Alamitos, CA with the most Remote Rn Coder job openings:
Remote Rn Coder jobs near you
Infographic showing various Remote Rn Coder job openings in Los Alamitos, CA as of July 2026, with employment types broken down into 6% Locum Tenens, 1% As Needed, 78% Full Time, 13% Part Time, and 2% Contract. Highlights an 62% Physical, 1% Hybrid, and 37% Remote job distribution, with an average salary of $46,977 per year, or $22.6 per hour.
Remote DRG Clinical Validation Reviewer (Coding RN)

Remote DRG Clinical Validation Reviewer (Coding RN)

Molina Healthcare

Long Beach, CA • On-site, Remote

$26.14 - $56.64/hr

Full-time

Posted 15 days ago

Molina Healthcare rating

8.1

Company rating: 8.1 out of 10

Based on 193 frontline employees who took The Breakroom Quiz

134th of 281 rated insurance

Job description


Job Description
Job Summary
Performs focused clinical reviews of inpatient and outpatient claims to verify that coded diagnoses, procedures, revenue codes, and corresponding reimbursement methodologies accurately reflect the patient's documented clinical condition, services rendered, and billed charges. Assesses medical records for clinical accuracy, acuity alignment, and documentation integrity. Identifies inconsistencies that impact reimbursement such as unsupported diagnoses, incorrect procedure coding, or inaccurate revenue code assignment and determines whether billed services meet coding and billing guidelines, payer policy, and regulatory requirements.
Job Duties
  • Reviews inpatient and/or outpatient claims to ensure diagnoses, procedures, revenue codes, itemized charges, and Diagnostic Related Groups (DRG) assignments accurately reflect the documented clinical condition and services provided.
  • Integrates ICD-10 coding principles, DRG methodologies, revenue code logic, and evidence-based clinical guidelines when reviewing claims for accuracy, appropriateness, and alignment with documentation.
  • Performs DRG validation reviews by verifying principal and secondary diagnoses, complications/comorbidities, procedure coding, severity level, and correct grouping logic.
  • Conducts itemized bill reviews to confirm that charges are supported by clinical documentation, compliant with billing standards, and appropriate for the level of care delivered.
  • Identifies unsupported, inaccurate, or inappropriate coding or billing elements such as unsubstantiated diagnoses, incorrect procedures, or incorrect revenue code usage.
  • Develops clear, evidence-based written rationales supporting diagnosis, procedure, revenue code, or DRG recommendations and determinations.
  • Substantiates all review outcomes using clinical indicators, documentation, coding guidelines, payer policy, and regulatory requirements.
  • Performs review work independently, applying sound clinical judgment and specialized expertise to evaluate complex claim scenarios.
  • Applies applicable federal/state regulations, official coding guidelines, payer policies, and Molina Payment Integrity standards during all reviews.
  • Ensures compliance with DRG and itemized bill review criteria, clinical validation rules, and reimbursement methodologies.
  • Collaborates with coding, payment integrity analytics, SIU, and physician advisors to clarify complex clinical documentation, coding discrepancies, or reimbursement determinations.
  • Provides subject-matter expertise on DRG validation, revenue code accuracy, itemized bill review, and documentation integrity to internal partners as needed.
  • Meets or exceeds established productivity goals set by Payment Integrity leadership for clinical validation and claim review activities.
  • Achieves the required accuracy and quality standards for review, diagnosis/procedure validation, and/or itemized bill reviews.
  • Participates in quality checks, calibration sessions, and ongoing training to maintain consistency and strengthen review competency.
  • Completes special projects and additional review assignments as delegated by leadership.
  • Identifies patterns and trends in documentation, coding, or billing that may require internal escalation, provider education, or process improvement.
  • Supports continuous improvement efforts by contributing insights that enhance review processes, criteria application, and workflow efficiency.

Job Qualifications
REQUIRED QUALIFICATIONS:
  • Registered Nurse (RN). License must be active and unrestricted in state of practice.
  • Requires a minimum of 2 years of experience in inpatient payment integrity medical claim review including DRG Validation or Itemized Bill Review, including 2 years' experience working with ICD-10, MS-DRG, AP-DRG and APR-DRG, CPT, HCPCS; or any combination of education and experience, which would provide an equivalent background.
  • Expert in DRG methodologies (e.g., MS & APR)
  • Expertise in UHDDS definitions, Official Inpatient Coding Guidelines, CMS and Medicaid State Guidelines for billing and coding, and AHA's Coding Clinic Guidelines
  • Expertise in evidence-based clinical decision support tools and clinical reference resources such as UpToDate, Merck Manual or similar
  • In-depth knowledge of clinical criteria and documentation requirements to support code assignments.
  • Proven ability to apply critical judgment in clinical and coding determinations.
  • Experience working within applicable state, federal, and third-party regulations.
  • Analytic, problem-solving, and decision-making skills.
  • Organizational and time-management skills.
  • Attention to detail.
  • Critical-thinking and active listening skills.
  • Effective verbal and written communication skills.
  • Microsoft Office suite and applicable software program(s) proficiency.

PREFERRED QUALIFICATIONS:
  • Certified Coding Specialist (CCS), Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Inpatient Coder (CIC), Clinical Documentation Improvement Practitioner (CDIP), Certified Professional Coder (CPC), or other advanced HIM/coding certifications.
  • Nursing experience in critical care, emergency medicine, medical/surgical, or pediatrics (including high-acuity areas such as ICU, ED, PICU, or NICU).

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

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About Molina Healthcare

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Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Long Beach, CA, US

Year founded

1980

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