- UPMC (Pittsburgh, PA)
- UPMC Health Plan has an exciting opportunity for a Clinical Auditor /Analyst Intermediate! The Clinical Auditor /Analyst Intermediate is an integral part ... establishes and revises better best practice within the department. The Clinical Auditor /Analyst Intermediate creates, maintains and analyzes auditing reports… 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 ... analyzing clinical documentation from the Electronic Health Record (EHR) compared...charges. + Hybrid position + Must live in BSWH Service area (Dallas preferred) - will be onsite for… 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 ... Practice Plan) is responsible for reviewing and verifying that all billable services and procedures provided to patients are accurately documented, coded, and… more
- Centene Corporation (Atlanta, GA)
- …findings, including clinical recommendations to assure the delivery of quality services + Lead case reviews to assess the clinical performance provided ... preferred. **Position Purpose:** Lead medical record audits, monitor and analyze clinical documentation, and modify business processes to measure member outcomes.… 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
- 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 ... procedures and educational materials + Acts as liaison with service operations as well as other areas of the...AS in nursing and minimum of 4 years of clinical nursing experience; or any combination of education and… 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 ... Summary: This positon trains and audits Inpatient and Outpatient Clinical Documentation Specialists (CDS) across all HCS entities that...are owned or managed that have opted into shared services . This position reports to the HCS Supervisor Coding… 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 : ... **Claims Auditor I, II and Senior** **Location :** This...the stop loss business, including complex specialized claims within Service Experience. Serves as the subject matter expert for… more
- Humana (Columbus, OH)
- …the accuracy, completeness, specificity and appropriateness of procedure codes based on services rendered + Review medical documentation for clinical indicators ... and help us put health first** The Medical Coding Auditor reviews medical claims submitted against medical records provided,...our customers and our company. Through our Humana insurance services and CenterWell healthcare services , we make… more
- Actalent (Paramus, NJ)
- Job Title: GCP Auditor /Senior Auditor , Quality AssuranceJob Description This position focuses on ensuring GXP compliance with regulatory authorities, driving and ... external audits, and providing support to the GXP QA Director across clinical operations, non- clinical , and manufacturing sectors. Responsibilities + Plan and… more
- Kelly Services (Lancaster, SC)
- **Quality Assurance Auditor ** **Location: Lancaster, South Carolina** **Schedule: Monday-Friday 8:30am-5pm** **Salary: $70,000-$95,000/year with a discretionary ... 12% of YTD earnings** **Position Summary** The Quality Assurance Auditor plays a key role in supporting and maintaining...you will have access to a retirement savings plan, service bonus and holiday pay plans (earn up to… more
- Eurofins US Network (Des Moines, IA)
- …international life sciences company, providing a unique range of analytical testing services to clients across multiple industries, to make life and our environment ... cosmetic product testing and in agroscience Contract Research Organisation services . It is one of the market leaders in...forensics, advanced material sciences and in the support of clinical studies, as well as having an emerging global… more
- Rush University Medical Center (Chicago, IL)
- …each case. **Summary:** As a key role in the Revenue Integrity team, the Auditor & Educator is responsible for conducting reviews of EMR documentation of patient ... accuracy and documentation adequacy. The professional will work collaboratively with clinical providers to improve revenue cycle integrity while seeking and… 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
- Community Health Systems (Franklin, TN)
- **Job Summary** The DRG Denials Auditor conducts hospital inpatient DRG denial audits for both RAC and non-RAC accounts, reviewing patient records for accuracy in ... ICD-10-CM/PCS coding, DRG assignments, and supporting clinical documentation. This includes evaluating present on admission (POA)...any other relevant data to ensure coding accuracy. The auditor is also responsible for writing and defending appeal… 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
- Sharp HealthCare (San Diego, CA)
- **Facility:** System Services **City** San Diego **Department** **Job Status** Regular **Shift** Day **FTE** 1 **Shift Start Time** **Shift End Time** Certified ... Clinical Documentation Specialist (CCDS) - Various-Employee provides certificate; Other;...remote position* **What You Will Do** The Compliance Coding Auditor is responsible for the administration of the Sharp… more
- Cedars-Sinai (Los Angeles, CA)
- …Under the general direction of the Manger or Associate Director, the Revenue Auditor Service Line performs audits of medical records against submitted ... bill and performs special audit requests for the department. The Revenue Auditor Service Line performs daily reconciliation of the submitted professional… more
- Northwell Health (Lake Success, NY)
- **Req Number** 172252 Surgical Anesthesia Compliance AuditorCompliance Auditor MUST HAVE CPC CERTIFICATON This is a HYBRID position- MUST be in the office located in ... Chappaqua, NY 3 days a week. Surgical Anesthesia Compliance Auditor - Hybrid position- Chappaqua, NY- $100K-$115K Are you passionate about healthcare compliance and… more
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