- UPMC (Pittsburgh, PA)
- …modification to company policies and procedures. + Perform audit peer reviews for Clinical Auditor /Analysts. + Provide new-hire training to Clinical ... UPMC Health Plan has an exciting opportunity for a Clinical Auditor /Analyst Intermediate! The Clinical ... care, documentation, and health plan business rules. + Provide a clinical opinion for special projects… more
- Baylor Scott & White Health (Dallas, TX)
- …vary based on position type and/or level **Job Summary** In this job, as a Clinical Auditor RN, you'll perform charge capture accuracy audits by reviewing and ... and provide counsel to Revenue Integrity team members and/or clinical departments/functions. + Documents and tracks audit findings for account corrections and… more
- Mount Sinai Health System (New York, NY)
- **Job Description** ** Clinical Revenue Auditor -CDM Patient Financial Services-Corporate-Full-Time-Days- Hybrid.** The Clinical Revenue Auditor for the ... financial health and compliance of the organization and bridges the gap between clinical care and medical billing and reimbursement. This position will report to the… more
- Elevance Health (Chicago, IL)
- **Diagnosis Related Group Clinical Validation Auditor -RN (CDI, MS-DRG, AP-DRG and APR-DRG)** **Virtual:** This role enables associates to work virtually ... an accommodation is granted as required by law. The **Diagnosis Related Group Clinical Validation Auditor ** is responsible for auditing inpatient medical records… more
- Elevance Health (Los Angeles, CA)
- ** Clinical Quality Auditor Lead** Must Have An Active Clinical License.** Location: **Virtual** - This role enables associates to work virtually full-time, ... 4:30 pm Or 9 am to 5:30 pm** The ** Clinical Quality Auditor Lead** is responsible for...Writes policies and procedures and assists with development of provider manuals, audit tools, and guidelines. + Responsible for… more
- St Croix Hospice (Mendota Heights, MN)
- …an extraordinary team of caregivers, then come work where you matter. Compliance Auditor ( Clinical ) Position Overview The Compliance Auditor is responsible ... and working cross-functionally to implement corrective actions. The Compliance Auditor will lead risk assessments, internal audits and compliance investigations… more
- UNC Health Care (Chapel Hill, NC)
- …from entity to entity across the state to train and shadow round with Clinical Documentation Specialists. The CDS auditor provides elbow to elbow support during ... we serve. Summary: This positon trains and audits Inpatient and Outpatient Clinical Documentation Specialists (CDS) across all HCS entities that are owned or… more
- Elevance Health (Boston, MA)
- … Auditor II** - all the above, plus: Independently interprets Medical Policy and Clinical Guidelines. + **Claims Auditor Senior** - all the above, plus : ... Service as a subject matter expert for Policy and Clinical Guidelines. Associates at this level serve as a...or any combination of education and experience which would provide an equivalent background. + **Claims Auditor … more
- Centene Corporation (Atlanta, GA)
- … documentation, and modify business processes to measure member outcomes. Assess provider performance and quality of care through clinical case reviews. ... + Lead clinical audits for provider medical records both remotely via electronic medical records...quality services + Lead case reviews to assess the clinical performance provided in the provider network,… more
- Insight Global (Plano, TX)
- …years working in an acute care setting or a third-party vendor as a DRG Auditor or Clinical Documentation Specialist (CDS). -CCS Certification RN or BSN RHIT or ... DRG Auditors to join a remote healthcare organization. The DRG Revenue Integrity Auditor will perform Diagnostic Related Group (DRG) validation and quality audits on… more
- Humana (Columbus, OH)
- …our caring community and help us put health first** The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and ... codes (eg, ICD-10-CM, CPT) to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis… more
- Humana (Madison, WI)
- …part of our caring community and help us put health first** The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record ... is complete, compliant and accurate to support optimal reimbursement. The Nurse Auditor 2 work assignments are varied and frequently require interpretation and… more
- Catholic Health (Buffalo, NY)
- …consistent, accurate, and meets data integrity for use in billing, reimbursement, clinical outcomes, and for reporting. The Auditor /Educator will monitor ... with coding conventions, billing rules and Federal and State regulations. The Auditor /Educator will also provide timely education and feedback for Clinicians,… more
- Aveanna Healthcare (Homestead, FL)
- …with Investigators, multi-disciplinary research team and Client Company representatives (eg, Clinical Research Associate (CRA), auditor ) Provide support ... Clinical Research Nurse - Illingworth (RN) ApplyRefer a...Nursing Salary: $50.00 - $55.00 per hour Position Details CLINICAL RESEARCH NURSE - Illingworth (RN) Job Overview: Aveanna… more
- Elevance Health (Atlanta, GA)
- **Nurse Auditor Senior - Payment Integrity Complex and Clinical Audit** **Location:** This role enables associates to work virtually full-time, with the ... providers through prepayment claims review, post payment auditing, and provider record review. **How you will make an impact:**...AS in nursing and minimum of 4 years of clinical nursing experience; or any combination of education and… more
- Actalent (Paramus, NJ)
- Job Title: GCP Auditor /Senior Auditor , Quality Assurance The GCP Quality Assurance Auditor /Senior Auditor will play a crucial role in ensuring compliance ... will conduct both internal and external GXP audits and provide day-to-day support to the GXP QA Director in... day-to-day support to the GXP QA Director in clinical operations, non- clinical , and manufacturing processes. This… more
- Eurofins US Network (Des Moines, IA)
- …discovery pharmacology, forensics, advanced material sciences and in the support of clinical studies, as well as having an emerging global presence in Contract ... also has a rapidly developing presence in highly specialised and molecular clinical diagnostic testing and in-vitro diagnostic products. In over 30 years, Eurofins… more
- TEKsystems (Annapolis, MD)
- Description JOB SUMMARY The Coding Auditor 1 is proficient in various types of coding and is responsible for performing coding quality audits and providing feedback ... to coders. The Coding Auditor 1 utilizes the International Classification of Disease (ICD-10-CM/PCS),...coding and abstracting system. * Works collaboratively with the Clinical Documentation Specialists and Coaches to communicate opportunities for… more
- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- **42910BR** **Extended Job Title:** Medical Coding Auditor **Org Level 1:** Texas Tech Unv Hlth Sci Ctr El Paso **Position Description:** Responsible for auditing ... compliance with healthcare laws and organizational policies. The Medical Coding Auditor collaborates with practice, providers, and other departmental leaders to … more
- Hartford HealthCare (Hartford, CT)
- …become part of Connecticut's most comprehensive healthcare network. The Revenue Compliance Auditor contributes to the success of the Office of Compliance and ... Integrity (OCI) by executing clinical documentation, coding and billing audits as assigned or...billing audits as assigned or scheduled. The Revenue Compliance Auditor performs independent reviews to assess compliance with federal,… more