- Omaha Children's Hospital (Omaha, NE)
- …and provides education/training regarding proper billing requirements. The Nurse Auditor will work collaboratively within Revenue Cycle, Compliance and ... 3 days post discharge to ensure accuracy and in compliance with regulatory requirements, hospital and system policies and...to accurately support billing and payment. In addition, the Nurse Auditor will complete requests for account… more
- Catholic Charities Family Community Services (Rochester, NY)
- ** Nurse Auditor ** **Job Details** **Job Location** 1099 Jay Street - Rochester, NY **Position Type** Per Diem **Education Level** Associates Degree **Salary ... Hourly **Travel Percentage** Negligible **Job Shift** Day **Description** **General Description** The Nurse Auditor will complete reviews of all medical records… more
- Childrens Hospital of The King's Daughters (Chesapeake, VA)
- + GENERAL SUMMARY + The Revenue Integrity Nurse Auditor is responsible for the auditing and compliance functions necessary to effect accurate and complete ... timely manner. + Prepares trend and other reports for compliance audits and charge processes. + Serves as a...CERTIFICATIONS + Current Virginia state license as a Registered Nurse or Registered Nurse holding a valid… more
- Rising Medical Solutions (Chicago, IL)
- …business was born - and continues to thrive. Rising Medical Solutions is looking for a Nurse Auditor who wants to make their mark in the world of medical cost ... team and maximize client savings by reviewing medical bills from a nurse perspective, including appropriate billing, coding and treatment, fee schedule compliance… more
- UNC Health Care (Chapel Hill, NC)
- **Description** **Our department of HIM-Revenue Integrity is seeking a Revenue Integrity Nurse Auditor to facilitate charge code auditing system-wide. This role ... with Revenue Integrity leadership and hospital departments to ensure compliance with clinical documentation and revenue cycle billing practices. **Description… more
- Northwell Health (Port Jefferson, NY)
- …Medicare/non-Medicare charts to ensure that proper standards are maintained in compliance with Federal and State regulations. 5.Applies coding rules and regulations ... the validation review process. 6.Reviews codes on Medicare/non-Medicare charts for compliance to rules and conventions. 7.Communicates DRG changes and rationale to… more
- Northwell Health (Garden City, NY)
- …reviews Medicare/non-Medicare charts to ensure that proper standards are maintained in compliance with Federal and State regulations. + Applies coding rules and ... the validation review process. + Reviews codes on Medicare/non-Medicare charts for compliance to rules and conventions. + Instructs professional staff in code… more
- InnovaCare (San Juan, PR)
- …MMM Holdings, Inc.Job Description Inpatient Unit POSITION: Concurrent Review Nurse (CRN) POSITION DESCRIPTION Manages the inpatient utilization of healthcare ... ICT and health assessments. Staff will notify supervisors of any processes not in compliance with the Plan's SNP policies and MOC requirements. Clinical staff who do… more
- UPMC (Pittsburgh, PA)
- **UPMC Corporate Finance is hiring a full-time Compliance Auditor , Intermediate. This position will be based out of Forbes Tower in Pittsburgh, PA. This position ... claims processing, data collection, and quality reporting. + Conduct audits on other compliance related topics as determined to evaluate compliance with the… more
- Chesapeake Regional Healthcare (Chesapeake, VA)
- Summary With direction from the Patient Financial Services Director, the Nurse Auditor / Revenue Integrity/ CDM Analyst is responsible for performing audits of ... and advising the billing staff of appropriate HCPCS codes and modifiers. The Nurse Auditor / Revenue Integrity/ CDM Analyst works directly with revenue producing… more
- UPMC (Pittsburgh, PA)
- UPMC Health Plan is looking for an Intermediate Clinical Auditor /Analyst to join the Quality Assurance team! This role will work standard daylight hours, Monday - ... Steel Tower, however, this role may work remotely. The Intermediate Clinical Auditor /Analyst is an integral part of the Quality Assurance and Operational Integrity… more
- HCA Healthcare (Nashville, TN)
- …Unlock your potential! **Job Summary and Qualifications** The Revenue Integrity Registered Nurse Auditor evaluates medical record documentation for evidence of ... colleagues invested over 156,000 hours volunteering in our communities. As a Revenue Integrity Auditor RN with Parallon you can be a part of an organization that is… more
- Actalent (Philadelphia, PA)
- …Essential Skills + 7 years of clinical research experience as a monitor/ auditor , research nurse , research coordinator, regulatory affairs, quality control, and ... Job Title: Clinical Research Auditor Job Description We are seeking a highly...human subjects clinical research and the principles of conducting compliance oversight. Responsibilities + Conduct thorough audits of clinical… more
- Vanderbilt University Medical Center (Nashville, TN)
- …Identifies areas for improvement for clinical documentation workflow, clinical query compliance , data integrity and training. * Reviews medical records to determine ... terminology and documentation in an office, or surgical setting. * Compliance (Advanced): Understanding the rules, regulations, sanctions and other statutory… more
- Ascension Health (Glendale, WI)
- **Details** + **Department: Recovery Audit Compliance ** + **Schedule: Full Time, Days, (M-F 8a-5p - some flexibility)** + **Hospital: AW Glendale Corporate Office** ... savings potential. **Requirements** Licensure / Certification / Registration: + Registered Nurse credentialed from the Wisconsin Board of Nursing obtained prior to… more
- R1 RCM (Boise, ID)
- …AI, intelligent automation, and workflow orchestration. As our **Clinical Coding Appeals Nurse ** , you will help review and interpret medical records to draft ... you will experience working as a Clinical Coding Appeals Nurse :** + Review and interpret medical records to appeal...a Clinical Validation Review by an insurer or third-party auditor . + Draft appeal letters that are well-written, logically… more
- University of Pennsylvania (Philadelphia, PA)
- …as well as assisting with corrective actions and training related to research compliance , quality control and quality assurance. The monitor/ auditor will follow ... field preferred. Minimum of seven years of experience as a clinical research monitor/ auditor , research nurse or research coordinator with at least three years'… more
- Molina Healthcare (NM)
- …Association** + Certified Professional in Health Quality (CPHQ) + Certified HEDIS Compliance Auditor (CHCA) + Registered Health Information Technician (RHIT), or ... **_JOB TITLE: Sr. Specialist, Quality Improvement RN (REGISTERED NURSE )_** **JOB DESCRIPTION** **Job Summary** Molina's Quality Improvement function oversees, plans,… more
- Molina Healthcare (Ypsilanti, MI)
- …Association** + Certified Professional in Health Quality (CPHQ) + Certified HEDIS Compliance Auditor (CHCA) + Registered Health Information Technician (RHIT), or ... **JOB DESCRIPTION** _For this position we are seeking a (RN) Registered Nurse who must live and have a current active unrestricted RN license in the state of MI_… more
- AdventHealth (Orlando, FL)
- …accurate reporting of enrollment and clinical trial performance, and billing compliance . * Reviews, interprets, and translates study documents such as protocols, ... accurately and timely provide builds that support the clinical, financial and compliance operations teams. * Contributes to quality control and assurance functions… more