Remote RN Clinical Auditor - Medicaid Billing Compliance
RADcube
- Remote job
RADcube is seeking a detail-oriented Registered Nurse Clinical Auditor to support medical record reviews and billing compliance audits for Indiana Health Coverage Programs. This remote role requires evaluating provider compliance, preparing audit documentation, and conducting reviews in alignment with healthcare guidelines. Applicants should preferably hold an RN license, coding certification, and have at least one year of experience in Medicaid claims review. Strong analytical and problem-solving skills are essential. The position offers occasional travel within Indiana. #J-18808-Ljbffr RADcube
$80k - $90k
...The Medical Review Clinical Appeals Auditor (RN) is responsible for... ...harassment and other compliance and policy/procedures... ...understanding CMS, Medicaid and/or Commercial insurance... ...relates to medical billing. Demonstrated... ...independently in remote setting with minimum...Remote workFor contractorsImmediate startWork from homeHome officeFlexible hoursShift work- ...Clinical Auditor Registered Nurse We are seeking a detail... ...record reviews, billing compliance audits for the Indiana... ...writing skills. This is a remote position with... ...national healthcare and Medicaid guidelines. Stay current... .... Requirements RN license preferred;...Remote workLocal area
$35 - $62.5 per hour
...Clinical DRG RN Auditor $10,000 SIGN ON BONUS FOR EXTERNAL APPLICANTS Optum... ..., and discharge statuses billed by hospitals to identify overpayments... ...knowledge of and compliance with changes and updates to... ...to work independently in a remote environment and deliver exceptional...Remote jobHourly payDaily paidMinimum wageFull timeTemporary workPart timeWork experience placementWork at officeLocal areaRelocation package$64k - $93k
...Job Summary The Clinical Auditor I performs detailed... ...You Full‑time remote work Competitive... ...plans, and medical billing documents to... ...completeness, and strict compliance with healthcare... ...years minimum RN experience in acute... ...and Family, and Medicaid plans. Founded in...Remote workFull timeContract workFlexible hours- ...Medical Billing Auditor Working at Yale means contributing... ...documentation for 18 clinical departments under the direction of the Compliance Officer. Provide training... ...is currently remote (work from home, in or... ...auditing, Medicare and Medicaid, or related clinical field...Remote workWork from home
$90k - $100k
...Compliance Auditor Help Protect the Integrity of Healthcare... ...of Medicare, Medicaid, PACE, Part D, LHCSA,... ...28 requirements. Billing and coding experience... ...work schedule with 2 remote workdays per week after... ...administrative, compliance, and clinical support services. We...Remote workTemporary work- ...Job Title: NC - RN Clinical Research Coordinator - Asheville... ...informed consent discussions in compliance with SOPs. Maintain accurate... ...ensure compliance with research billing practices. Critical... ...Friday 8:00 AM - 5:00 PM. Remote work possible as required....Remote workFull timeMonday to Friday
$68.57k - $104.84k
...a DRG Quality Control/Clinical Auditor. The Diagnostic Related... ...rules. This is a remote position. ESSENTIAL... ...determine accuracy of billing through verification of... ...including Medicare and Medicaid Understand and... ...EXPERIENCE: LVN or RN license in the state of...Remote workMinimum wageFull timeWork at officeLocal areaFlexible hours- RN Inpatient Hospital Auditor - Remote (New Jersey) - 6‑month contract, 3+ years experience... ...of Centers of Medicare & Medicaid Prospective Payment... ...site audits of hospital billing and coding practices and... ...with new innovations in clinical data review and company cost...Remote jobWeekly payDaily paidContract workLocal areaImmediate start
- ...is looking for a Corporate Compliance Clinical Auditor to join our teams’ mission... ...to assess compliance with billing, coding, documentation, and... ...Active clinical license (RN, LPN, PT/OT/ST, etc.) Certifications... ...7 years of experience in Medicaid, Medicare, & Managed Care...Work experience placementWork at office
$75k - $90k
...You’ll Do The Coding Compliance Auditor partners cross-functionally with clinical leadership, revenue cycle... ...internal policies in a remote-first, high-growth... ...guidelines (e.g., AHIMA, CMS, Medicaid), and payer-specific... ...specific Medicaid and payer billing requirements, maintain...Remote workFull timeTemporary work$56.17k - $70.22k
...is hiring for a Medical Coding Auditor to join our Compliance Team. This opportunity is a REMOTE, full-time, day shift opening located... ...knowledge of UNM Medical group billing systems procedures to provide a... ...codes, medical diagnoses and clinical procedures ensuring that...Remote workPermanent employmentFull timeFor contractorsLive inWork from homeRelocationRelocation packageDay shift- ...Fraud, Waste, and Abuse Auditor Under the general... ..., waste and abuse for Medicaid programs. A major function... ...types to ensure compliance with federal and state... ...leads and detect aberrant billing practices, including... ...aspects of the job are remote. Responsibilities...Remote workWork at office
$82.23k - $155.81k
Elevance Health is seeking a Diagnosis Related Group Clinical Validation Auditor-RN to ensure clinical documentation accuracy for inpatient records. This role offers flexibility through virtual work. The ideal candidate will analyze claims, maintain auditing standards,...Remote job$96.46k - $144.69k
A major healthcare organization in New York is seeking a Clinical Revenue Auditor to ensure accurate documentation and coding of billable services. This full-time role offers a hybrid work option and involves auditing clinical revenue processes. Ideal candidates will have...Remote jobFull time- ...leading healthcare provider in New York seeks a Clinical Revenue Auditor to ensure the accuracy of medical billing and compliance with regulations. Ideal candidates will have... ...full-time role offers the option to work remotely or in a hybrid setting, contributing to the...Remote jobFull time
$64k - $93k
Join WellSense Health Plan as a Clinical Auditor I, where you'll conduct detailed audits... ...ensure accurate reimbursement and compliance with regulations. This remote role is vital in maintaining... ...documentation. We're looking for an RN with a Bachelor's degree and experience...Remote job- Optum is hiring a Clinical DRG RN auditor to verify DRG coding accuracy and reimbursements while telecommuting from anywhere in the U.S. In this role, you'll use your ICD-10 coding expertise to audit inpatient claims, identify overpayments, and support your findings with...Remote job
- The Clinical Chart Auditor is responsible for conducting systematic reviews of... ...retina-specific services. Remote work options may be available... ...deficiencies and compliance gaps (cloned notes, insufficient... ...actionable insights to leadership, billing, and clinical teams for...Remote workFull timeWork at office
$45.67 per hour
Auditor Clinical Validation Outpatient Specialty Clinical Job Locations US-Remote ID 2026-18743 Category Audit - Healthcare Position... ...from a coding and billing perspective: SNF, IRF, Home... ...and CMS and other regulatory compliance guidelines and mandates. Requires...Remote workHourly payFull timeContract workWork at officeImmediate start- ...p, hybrid (3 days on site, 2 remote) Key Functions Medical record... ..., progress notes, other clinical documentation to determine services... ...documentation to ensure compliance with third party and... ...ensure all services that can be billed are captured and coded for billing...Remote workMonday to FridayShift work
- ...RN Clinical Auditor Smithfield, RI - Smithfield, RI 02917 Overview Position Type: Full... ...identify aberrant or potentially fraudulent billing patterns. The RN Clinical Auditor will... ...investigations to management, SIU and Compliance team members, internal business leads...Full timeContract workWork at officeShift work
- ...Clinical Auditor/Analyst Position UPMC Health Plan has an exciting opportunity... ...daylight hours and will be a remote position. The Clinical... ...as needed; analysis of billing by providers/physicians, and... ...Requirements: Registered Nurse (RN). Five years of clinical...Remote jobFull timeWork at officeLocal areaMonday to Friday
- ...is seeking a Revenue Protection Specialist to manage external audits and support compliance initiatives. This role requires a clinical background in nursing and strong knowledge of billing practices. The successful candidate will oversee audit responses, implement process...
$82.23k - $155.81k
Title Diagnosis Related Group Clinical Validation Auditor‑RN (CDI, MS‑DRG, AP‑DRG and APR‑DRG) Virtual This role enables associates to work virtually... ...coding and documentation patterns such as inappropriate billing for readmissions, inpatient admission status, and...Full timeWork at officeLocal area- ...A healthcare organization is seeking a Clinical Services Specialist RN to perform reviews of patient records for medical necessity compliance. This full-time role involves analyzing records according to policies and facilitating communication with various stakeholders...Remote workFull timeWork from home
$37.84 - $58.75 per hour
Providence is calling for Compliance Auditor - Remote The Revenue Cycle Compliance Hospital Auditor conducts... ...focus for this position may involve clinical and non-clinical services, including... ...: Rev Cycle departments, Rev Cycle Billing Offices, External Vendor; HIM Coding,...Remote workMinimum wageFull timeLocal areaShift work- ...Nurse Auditor Have you ever looked a medical bill and immediately noticed something was wrong? Were you itching... ...and treatment, fee schedule compliance, over-utilization, and erroneous... ...reasonable, appropriate and necessary. Clinically identify and evaluate any charges...Remote workImmediate start
$59.3k - $80.9k
...The Medical Coding Auditor reviews medical... ...documentation for clinical indicators to ensure... ...reviews to ensure compliance with coding guidelines... ...WORK STYLE: Remote, work at home. While... ...Itemized Bill reviews ~ Ambulatory... ...with Medicare and Medicaid, families, individuals...Remote workBi-weekly payFull timeContract workTemporary workApprenticeshipWork at officeWork from homeHome officeMonday to Friday$105k - $135k
.... Job Summary The Clinical AI Specialist, RN - Medical Coding is a unique... ...affect reimbursement and compliance will directly shape how... ...CMS guidelines, Medicare/Medicaid billing rules, and payer-specific... ...Requirements This role is remote-friendly. Occasional...Remote workFull timeContract workPart timeLive inFlexible hours
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