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Work From Home Rn Rac Auditor Jobs (NOW HIRING)

BrightStar Care API

Registered Nurse Case Manager

Non-skilled work in member's homes to prevent hospital readmission * Teaching and helping members ... Training and document done from home Registered Nurse (RN) Case Manager Job Requirements include ...

AO Globe Life

Work From Home

Virginia Beach, VA · On-site +1

Join our fully virtual, work-from-home team where you can earn an exceptional income while still cherishing every precious moment with your loved ones. With the freedom to set your own hours, you can ...

AO Globe Life

Work From Home

Virginia Beach, VA · On-site +1

Join our fully virtual, work-from-home team where you can earn an exceptional income while still cherishing every precious moment with your loved ones. With the freedom to set your own hours, you can ...

AO Globe Life

Work From Home

Virginia Beach, VA · On-site +1

Join our fully virtual, work-from-home team where you can earn an exceptional income while still cherishing every precious moment with your loved ones. With the freedom to set your own hours, you can ...

AO Globe Life

Work From Home

Virginia Beach, VA · On-site +1

Join our fully virtual, work-from-home team where you can earn an exceptional income while still cherishing every precious moment with your loved ones. With the freedom to set your own hours, you can ...

AO Globe Life

Work From Home

Virginia Beach, VA · On-site +1

Join our fully virtual, work-from-home team where you can earn an exceptional income while still cherishing every precious moment with your loved ones. With the freedom to set your own hours, you can ...

The Jernigan Agency

WORK FROM HOME

Oklahoma City, OK · On-site +1

$300 - $500/wk

We are looking for individuals interested in working from home, remotely, as life insurance sales representatives. We are hiring coachable individuals comfortable with a 100% commission based income ...

The Jernigan Agency

WORK FROM HOME

Kansas City, KS · On-site +1

$300 - $500/wk

We are looking for individuals interested in working from home, remotely, as life insurance sales representatives. We are hiring coachable individuals comfortable with a 100% commission based income ...

The Jernigan Agency

WORK FROM HOME

Shreveport, LA · On-site +1

$300 - $500/wk

We are looking for individuals interested in working from home, remotely, as life insurance sales representatives. We are hiring coachable individuals comfortable with a 100% commission based income ...

The Jernigan Agency

WORK FROM HOME

Washington, DC · On-site +1

$300 - $500/wk

We are looking for individuals interested in working from home, remotely, as life insurance sales representatives. We are hiring coachable individuals comfortable with a 100% commission based income ...

The Jernigan Agency

WORK FROM HOME

Grand Rapids, MI · On-site +1

$300 - $500/wk

We are looking for individuals interested in working from home, remotely, as life insurance sales representatives. We are hiring coachable individuals comfortable with a 100% commission based income ...

The Jernigan Agency

WORK FROM HOME

West Valley City, UT · On-site +1

$300 - $500/wk

We are looking for individuals interested in working from home, remotely, as life insurance sales representatives. We are hiring coachable individuals comfortable with a 100% commission based income ...

The Jernigan Agency

WORK FROM HOME

Detroit, MI · On-site +1

$300 - $500/wk

We are looking for individuals interested in working from home, remotely, as life insurance sales representatives. We are hiring coachable individuals comfortable with a 100% commission based income ...

The Jernigan Agency

WORK FROM HOME

Boston, MA · On-site +1

$300 - $500/wk

We are looking for individuals interested in working from home, remotely, as life insurance sales representatives. We are hiring coachable individuals comfortable with a 100% commission based income ...

The Jernigan Agency

WORK FROM HOME

Mesa, AZ · On-site +1

$300 - $500/wk

We are looking for individuals interested in working from home, remotely, as life insurance sales representatives. We are hiring coachable individuals comfortable with a 100% commission based income ...

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All JobsRn Rac Auditor JobsWork From Home Rn Rac Auditor Jobs

Work From Home Rn Rac Auditor information

See salary details

$41.5K

$78.2K

$125K

How much do work from home rn rac auditor jobs pay per year?

As of Jul 28, 2026, the average yearly pay for work from home rn rac auditor in the United States is $78,163.00, according to ZipRecruiter salary data. Most workers in this role earn between $58,500.00 and $89,500.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Work From Home RN RAC Auditor, and why are they important?

To thrive as a Work From Home RN RAC Auditor, you need a registered nursing license, strong clinical knowledge, and expertise in healthcare compliance and coding practices. Familiarity with electronic medical records (EMRs), audit software, and CMS guidelines is typically required, along with certifications such as CCDS or CPMA being advantageous. Exceptional attention to detail, analytical thinking, and effective communication skills help auditors interpret regulations and collaborate remotely. These skills and qualifications are crucial for ensuring accurate claims review, regulatory compliance, and minimizing financial risk for healthcare organizations.

What are some common challenges faced by Work From Home RN RAC Auditors, and how can they be managed?

Work From Home RN RAC Auditors often face challenges such as staying updated with frequently changing Medicare guidelines, maintaining effective communication with remote teams, and managing a high volume of medical record reviews within tight deadlines. To overcome these challenges, it’s helpful to establish a structured daily routine, utilize digital collaboration tools, and participate in ongoing training. Regular check-ins with supervisors and peers can also help ensure alignment and support while working remotely.

What are Work From Home RN RAC Auditors?

Work From Home RN RAC Auditors are Registered Nurses who review medical records remotely to ensure compliance with healthcare regulations and reimbursement guidelines. RAC stands for Recovery Audit Contractor, a program that audits hospitals and healthcare providers to identify and correct improper Medicare payments. These auditors evaluate documentation, billing, and coding practices to prevent fraud, waste, and abuse. Working from home, they use secure systems to access records and often communicate with providers and other staff virtually.

What is the difference between Work From Home Rn Rac Auditor vs Work From Home Rn Medicare Auditor?

AspectWork From Home Rn Rac AuditorWork From Home Rn Medicare Auditor
CredentialsRegistered Nurse (RN), RAC certificationRegistered Nurse (RN), Medicare auditing certification
Work EnvironmentRemote, healthcare and insurance companiesRemote, healthcare insurance companies
Industry UsageHealthcare, insurance, government programsHealthcare, insurance, government programs
Job FocusReviewing RAC (Recovery Audit Contractor) claims for MedicareAuditing Medicare claims for compliance and reimbursement

Both roles involve remote healthcare auditing with RN credentials, but Work From Home Rn Rac Auditors focus on RAC claims specifically, while Work From Home Rn Medicare Auditors handle broader Medicare claim audits. The choice depends on the specific certification and job focus within Medicare auditing.

More about Work From Home Rn Rac Auditor jobs
What states have the most Work From Home Rn Rac Auditor jobs? States with the most job openings for Work From Home Rn Rac Auditor jobs include:
What job categories do people searching Work From Home Rn Rac Auditor jobs look for? The top searched job categories for Work From Home Rn Rac Auditor jobs are:
Work From Home Rn Rac Auditor jobs near you
Infographic showing various Work From Home Rn Rac Auditor job openings in the United States as of July 2026, with employment types broken down into 25% Locum Tenens, 66% Full Time, 6% Part Time, 1% Contract, and 2% Summer. Highlights an 87% Physical, 6% Hybrid, and 7% Remote job distribution, with an average salary of $78,163 per year, or $37.6 per hour.
Medical Review Nurse - CMS/RAC Auditor, Government Audits

Medical Review Nurse - CMS/RAC Auditor, Government Audits

Machinify

Remote

Full-time

Posted 3 days ago

Job description

Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plan clients across the country. Deployed by over 85 health plans, including many of the top 20, and representing more than 270 million lives, Machinify brings together a fully configurable and content-rich, AI-powered platform along with best-in-class expertise. We're constantly reimagining what's possible in our industry, creating disruptively simple, powerfully clear ways to maximize financial outcomes and drive down healthcare costs.
The Medical Review Nurse - CMS / RAC (Government Audits) primarily performs medical claims audit reviews for government clients. As a MR Nurse, you will join a team of experienced medical auditors and coders performing retrospective and prepayment audits on claims for Government Payers. You will work remotely in a fast paced and dynamic environment and be part of a multi-location team.
Please note: RAC certification is preferred for this role. The selected candidate may need to work toward RAC certification if they do not currently have it.
Key Responsibilities:
  • Auditing claims for medically appropriate services provided in both inpatient and outpatient settings while applying appropriate medical review guidelines, policies and rules.
  • Document all findings referencing the appropriate policies and rules.
  • Generate letters articulating audit findings.
  • Supporting your findings during the appeals process if requested.
  • Working collaboratively with the audit team to identify and obtain approval for particular vulnerabilities and/or cases subject to potential abuse.
  • Work in partnership with our clients, CMD colleagues, and other contractors on improving medical policies, provider education, and system edits.
  • Keep abreast of medical practice, changes in technology, and regulatory issues that may affect our clients.
  • Work with the team to minimize the number of appeals; Suggest ideas that may improve audit workflows; Assist with QA functions and training team members.
  • Participate in establishing edit parameters, new issue packets and development of Medical Review Guidelines.
  • Interface with and support the Medical Director and cross train in all clinical departments/areas.
  • Other duties as required to meet business needs.

Knowledge, Skills and Abilities Needed:
  • Experience with utilization management systems or clinical decision-making tools such as Medical Coverage Guidelines (MCG) or InterQual.
  • Experience with and deep knowledge of ICD-9, ICD-10, CPT-4 or HCPCS coding.
  • Knowledge of insurance programs program, particularly the coverage and payment rules.
  • Ability to maintain high quality work while meeting strict deadlines.
  • Excellent written and verbal communication skills.
  • Ability to manage multiple tasks including desk audits and claims review.
  • Must be able to independently use standard office computer technology (e.g. email telephone, copier, etc.) and have experience using a case management system/tools to review and document findings.
  • Must be able to manage multiple assignments effectively, create documentation outlining findings and/or documenting suggestions, organize and prioritize workload
  • Effectively work independently and as a team, in a remote setting.

Required and Preferred Qualifications:
  • Active unrestricted RN license in good standing, is required.
  • Must not be currently sanctioned or excluded from the Medicare program by the OIG.
  • Minimum of five (5) years diversified nursing experience providing direct care in an inpatient or outpatient setting.
  • One (1) or more years' experience performing medical records review.
  • One (1) or more years' experience in health care claims that demonstrates expertise in, ICD-9/ICD-10 coding, HCPS/CPT coding, DRG and medical billing experience for an Insurance Company or hospital required.
  • Strong preference for experience performing utilization review for an insurance company, Tricare, MAC, or organizations performing similar functions.
  • RAC certification preferred.

Equal Employment Opportunity at Machinify
We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender, gender identity or expression, or veteran status. We are proud to be an equal opportunity workplace. Machinify is an employment at will employer. We participate in E-Verify as required by applicable law. In accordance with applicable state laws, we do not inquire about salary history during the recruitment process. If you require a reasonable accommodation to complete any part of the application or recruitment process, please let our recruiters know. See our Candidate Privacy Notice at: https://www.machinify.com/candidate-privacy-notice/

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