RN Nurse Auditor with Insurance Experience Job at GHR Healthcare, Houston, TX

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  • GHR Healthcare
  • Houston, TX

Job Description

Registered Nurse Auditor (RN Auditor) – Remote Insurance Payer Audits

Join our healthcare team as a remote Registered Nurse Auditor supporting insurance payer audits, denial management, billing compliance, and charge capture validation. This Houston, Texas–connected opportunity is ideal for an experienced RN with healthcare revenue cycle and claims review expertise.

The ideal candidate combines clinical nursing knowledge with strong revenue cycle experience and can independently review claims, interpret denial rationales, validate medical documentation, and communicate effectively with insurance carriers. You will help explain charges, documentation support, coding considerations, and reimbursement rationale during payer audit reviews while enjoying the flexibility of a remote, work-from-home role.

Remote RN Auditor Job Details

  • Work Arrangement: Remote / work from home
  • Location: Houston, Texas area (ZIP 77024), with access to Houston's diverse communities, exceptional dining, cultural attractions, and convenient local amenities
  • Weekly Estimated Pay: $1,830–$1,970
  • Schedule: 5 shifts per week
  • Shift Duration: 8-hour days
  • Hours: Approximately 36 hours per week, with workload varying according to payer audit volume
  • Duration: 26-week assignment
  • Start Date: October 15, 2026

Registered Nurse Auditor Job Requirements

  • Active Registered Nurse (RN) license
  • At least 1 year of experience in nurse auditing, healthcare revenue cycle, utilization review, claims review, or a closely related area
  • Previous experience with insurance payer audits and denial management
  • Working knowledge of billing compliance, charge capture, medical documentation, and reimbursement practices
  • Ability to interpret denial rationales and identify appropriate documentation or clinical support for appeals and audit responses
  • Strong written and verbal communication skills, including the ability to communicate confidently with insurance carriers
  • Strong analytical, organizational, and time-management skills
  • Ability to work independently in a remote environment and manage changing audit volumes

Insurance Payer Audit Responsibilities

  • Review insurance payer audit requests, claims, medical records, charges, and related clinical documentation
  • Evaluate claim denials and determine the underlying rationale for nonpayment
  • Validate billing compliance, charge capture accuracy, and documentation support
  • Prepare clear, accurate, and timely responses to payer audits and denial challenges
  • Represent the healthcare organization professionally during payer audit reviews
  • Advocate for appropriate reimbursement by connecting billed services and charges to clinical documentation and applicable payer requirements
  • Track audit assignments, response deadlines, findings, and outcomes
  • Collaborate with clinical, coding, billing, and revenue cycle teams to resolve audit findings and reduce recurring denials
  • Prioritize work effectively as audit volume fluctuates, including periods of heightened activity

Apply now to advance your career in this remote Registered Nurse Auditor opportunity supporting insurance payer audits, healthcare revenue cycle operations, and reimbursement accuracy in the Houston, Texas area.

Benefits

401K with Matching, Healthcare, Dental and Vision

Equal Opportunity

We are an equal opportunity employer and value diversity across our organization. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

Job Tags

Weekly pay, Full time, Local area, Remote work, Shift work

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