- Molina Healthcare (FL)
- …+ Performs monthly auditing of registered nurse and other clinical functions in Utilization Management (UM), Case Management (CM), Member ... Management (HM), and/or Disease Management (DM). + Monitors key clinical staff for compliance with NCQA, CMS, State and...NCQA, CMS, State and Federal requirements. May also perform non- clinical system and process audits, as needed. + Assesses… 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 ... Tower, however, this role may work remotely. The Intermediate Clinical Auditor /Analyst is an integral part of...audits and reviews regarding the analysis of care and services related to clinical guidelines, coding requirements,… more
- Providence (WA)
- …retain the best people, we must empower them._** **Providence Health Plan is calling a Clinical Nurse Auditor , HEDIS who will:** + Be responsible for conducting ... clinical quality audits for the Quality Department + Identify...Learn more at providence.jobs/benefits. **About the Team** Providence Shared Services is a service line within Providence… more
- Vanderbilt University Medical Center (Nashville, TN)
- …* Conducts audits to ensure accurate and complete data for the clinical documentation improvement program. Advises staff with regards to clinical ... correct diagnosis and procedure codes. * Identifies areas for improvement for clinical documentation workflow, clinical query compliance, data integrity and… more
- RWJBarnabas Health (Oceanport, NJ)
- FT Internal Auditor Senior II ( Remote - Hybrid)Req #:0000158945 Category:Professional / Management Status:Full-Time Shift:Day Facility:RWJBarnabas Health ... Corporate Services Department:Internal Audit Location: System Business Office, 2 Crescent...risks to the organization. Work assigned to the Internal Auditor Senior II will often be well-defined but may… more
- Providence (OR)
- …and much more. Learn more at providence.jobs/benefits. **About the Team** Providence Shared Services is a service line within Providence that provides a variety ... them._** **Providence Health Plan is calling a Coding Quality Auditor , HEDIS who will:** + Be responsible for conducting..., HEDIS who will:** + Be responsible for conducting clinical quality audits/overreads for the Quality Department + Identify… more
- Fallon Health (Worcester, MA)
- …is continually rated among the nation's top health plans for member experience, service , and clinical quality. We believe our individual differences, life ... of audits following departmental standards and procedures. **The Internal Auditor will perform or assist in the following:** +...plans by working under the direction of the Lead Auditor or Audit Manager. + Prepare detailed work papers… more
- Trinity Health (Albany, NY)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** **Revenue Integrity Nurse Auditor - Remote - St. Peter's Hospital - FT Days** If you are ... Business Service (PBS) center and ensures compliant and complete clinical documentation, assists with denials and related appeals, and identifies opportunities… more
- Rising Medical Solutions (Chicago, IL)
- …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 containment. Join ... compliance, over-utilization, and erroneous charges. We pride ourselves on outstanding customer service and work hard to keep our impeccable reputation in the… more
- Trinity Health (Boise, ID)
- …to achieve your potential. Living by these virtues, we pride ourselves on exceptional service and the highest quality of care. We are looking for a new **Revenue ... Integrity Auditor ** to join our team, working in coordination with...is not limited to: regulatory reviews, audit reviews of pre- service , time of service and post … more
- UPMC (Pittsburgh, PA)
- **UPMC is hiring a full-time Senior Medical Auditor to join their Department of Pediatrics team! This position will join our Pediatrics administrative team, which ... external coding audits when requested.** As the Senior Medical Auditor , you will provides technical expertise to review staff...expertise to review staff to ensure that all physicians, clinical , billing and coding staff are adhering to all… more
- ThermoFisher Scientific (Austin, TX)
- …Conditions** Office **Job Description** Conduct complex internal and external Clinical Research Site audits to ensure compliance with established quality ... contractual obligations. Identify issues impacting the quality and/or integrity of clinical research programs, determine root cause of non-conformance and develops… more
- Ascension Health (Wichita, KS)
- …Holidays + **Hospital:** Ascension Via Christi, St. Francis + **Location** Wichita, KS--may be remote , but must be able to travel to the area as needed **Benefits** ... specifics._ **Responsibilities** Develop, implement, and has oversight over the Clinical Documentation Integrity (CDI) audit plan, utilizing audit findings to… more
- BayCare Health System (NC)
- …7:00 AM to 3:30 PM + **Days:** Monday - Friday The **Inpatient** **Coding Auditor ** is a full-time remote position. This team member must currently reside ... Team Member who is passionate about providing outstanding customer service to our community. We are looking for an...the Tampa Bay area. **Position Details:** + **Location:** Fully Remote (must reside in the State of Florida, Georgia,… more
- Hackensack Meridian Health (Hackensack, NJ)
- …serve as a leader of positive change. The **Diagnosis Related Group (DRG) Auditor ** is responsible for auditing clinical documentation that supports code ... includes compliance with the Conditions of Participation for CMS. The DRG auditor is responsible for ensuring coding accuracy, coding consistency and efficiency in… more
- State of Maine, Bureau of Human Resources (Augusta, ME)
- Staff Auditor II Augusta , Maine , United States | Auditor | Full-time | Partially remote Apply by: Dec. 31, 2024 Apply with Linkedin Apply Department of ... Health and Human Services (DHHS)Opening Date: November 27, 2024Closing Date: December 31,...to its staff. ABOUT THE POSITION: As a Staff Auditor II you will: + Perform independent and complex… more
- AdventHealth (Maitland, FL)
- **Coding Auditor Inpatient** **Work Hours/Shift:** + Full Time Remote **You Will Be Responsible For:** + Performs quality reviews on coded records to validate ... and overall accuracy of coding + Reviews, analyzes, and interprets clinical documentation, seeking clarification from the physician when discrepancies exist.… more
- Lucile Packard Children's Hospital Stanford (Palo Alto, CA)
- …the general nature, level and purpose of the job. The Senior Charge Capture Auditor works closely with clinical departments to ensure compliance with government, ... Revenue Cycle 1.0 FTE, 8 Hour Day Shift, Onsite-Not Remote At Stanford Children's Health, we know world-renowned care begins with world-class caring. That's why we… more
- Columbus Regional Hospital (Columbus, IN)
- …documentation compliance to determine appropriate code assignments for diagnoses and services performed (HCPCS/CPT codes). + Develops quality audit reports that ... trends and educational opportunities. + Responsible for training and educating providers, clinical staff, and departments, one-on-one and in a group setting, on all… more
- R1 RCM (Boise, ID)
- R1 is a leading provider of technology-enabled revenue cycle management services which transform and solve challenges across health systems, hospitals and physician ... reducing operating costs and enhancing the patient experience. The Coding Denial Auditor will be responsible for reviewing denial coded cases for coding completeness… more