- Medical Mutual of Ohio (OH)
- … experience, DRG,_** **_and/or_** **_hospital bill auditing experience._** **Responsibilities** ** Clinical Auditor ** + **Audits outpatient, inpatient and ... recovery staff.** + **Performs other duties as assigned.** **Sr Clinical Auditor ** + **Audits outpatient, inpatient and...Auditor ** **Education and Experience** + Graduate of a registered nursing program approved by the Ohio State Nursing… more
- LA Care Health Plan (Los Angeles, CA)
- Delegation Oversight Clinical Auditor RN II Job Category: Clinical Department: Audit Services Location: Los Angeles, CA, US, 90017 Position Type: Full ... to achieve that purpose. Job Summary The Delegation Oversight Clinical Auditor RN II is...& literacy with Word, Excel, PowerPoint Skills. Licenses/Certifications Required Registered Nurse ( RN ) - Active,… more
- Elevance Health (Columbus, OH)
- …would provide an equivalent background. + Requires current, active, unrestricted Registered Nurse license in applicable state(s). **Preferred Skills, ... **Diagnosis Related Group Clinical Validation Auditor ** **Location:** This position...are preferred: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Clinical … more
- Elevance Health (Metairie, LA)
- ** Clinical Quality Auditor Sr.** **Location** : The territory for this position is the State of Louisiana. The ** Clinical Quality Auditor Sr.** is ... Requires BS in nursing, health sciences, health management or a related clinical field and minimum of 5 years of experience in utilization management,… more
- Centene Corporation (Tallahassee, FL)
- …training programs and auditing tools for the Payment Integrity department. The Trainer- Auditor ( Clinical ) is fully remote. Candidates will be considered ... + Conduct training needs analyses to determine specific training needs for clinical staff + Identify, select, or develop appropriate training programs, including the… more
- SSM Health (MO)
- …Illinois Department of Financial and Professional Regulation (IDFPR) State of Work Location: Missouri + Registered Nurse ( RN ) Issued by Compact State + Or + ... compliant with regulatory requirements and standards are maintained. Performs clinical audits within Care Transformation operations by supporting the...Registered Nurse ( RN ) - Missouri Division of Professional… more
- Actalent (St. Louis, MO)
- Quality Improvement Auditor ( RN ) Position Purpose: Lead medical record audits, monitor and analyze clinical 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… more
- Molina Healthcare (Dallas, TX)
- **KNOWLEDGE/SKILLS/ABILITIES** + Performs monthly auditing of registered nurse and other clinical functions in Utilization Management (UM), Case Management ... Management (HM), and/or Disease Management (DM). + Monitors key clinical staff for compliance with NCQA, CMS, State and...them. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ) Program and… more
- Actalent (St. Louis, MO)
- The Quality Improvement Auditor RN will be responsible for leading medical record audits, monitoring and analyzing clinical documentation, and modifying ... also be responsible for assessing provider performance and quality of care through clinical case reviews. Other duties include: + Leading clinical audits via… more
- CommonSpirit Health Mountain Region (Colorado Springs, CO)
- …with resources to help you flourish and leaders who care about your success. The clinical auditor performs clinical and operational audits as a means of ... of OR operations, types of cases being done. Solid clinical understanding of all clinical aspects of... aspects of the OR required Must be an RN with OR experience 16 OR Suites Approx. 250-350+… more
- Houston Methodist (Cypress, TX)
- …to accurately support reasons for treatment, billing, payment or operations. The Nurse Auditor position ensures clinical documentation supports all ... At Houston Methodist, the Nurse Auditor position is responsible auditing...or hospital setting **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -… more
- University of Pennsylvania (Philadelphia, PA)
- …or related field preferred. Minimum of seven years of experience as a clinical research monitor/ auditor , research nurse or research coordinator with ... Department of Operations, Compliance and Monitoring (DOCM) is seeking a clinical research monitor/ auditor to support our clinical research mission. The… more
- Northwell Health (Garden City, NY)
- …five (5) years of job entry date. + Current License to practice as a Registered Professional Nurse in New York State required, plus specialized certifications as ... **Req Number** 125752 Job Description Seeking RN - BSN or MSN candidates with a...- Home Care Coding Specialist-Diagnosis, COS-C Certificate for OASIS Specialist- Clinical . Conducts Home Health Resource Group (HHRG) Validation to… more
- Northwell Health (Garden City, NY)
- …combination of education and related experience. 2.Current License to practice as a Registered Professional Nurse in New York State required, plus specialized ... **Req Number** 137052 Job Description **Seeking RN - BSN or MSN candidates with a...- Home Care Coding Specialist-Diagnosis, COS-C Certificate for OASIS Specialist- Clinical .** Validates Acute Inpatient coded charts to ensure the… more
- Providence (CA)
- **Description** **Revenue Cycle Auditor RN \*Remote * Candidates residing in AK, WA, MT, OR, CA, TX or NM are encouraged to apply.** The Nurse Auditor is ... Associate's Degree - Nursing Or a Bachelor's Degree - Nursing. + 5 years - Clinical experience in an acute care setting. + 3 years - Experience actively utilizing… more
- Somatus (Mclean, VA)
- …clinical experience in dialysis or renal care setting is a must. * Current Registered Nurse compact state licensure and other states as deemed necessary by ... and mental well-being + Community engagement opportunities + And more! The Quality Auditor effectively and efficiently manages a diverse workload in a fast- paced,… more
- Grace Healthcare Services (Edison, NJ)
- …compliance through other clinical quality improvement initiatives. QUALIFICATIONS: NJ Registered Nurse or Licensed Practical Nurse required, Bachelors ... highest level of dignity and grace. PURPOSE: The Compliance Auditor is an experienced nurse to oversee... to oversee the primary responsibility of auditing patient clinical records to ensure state and federal compliance. Also… more
- BayCare Health System (FL)
- …and Licensures** + Required - RHIA/RHIT in conjunction with CCS + Preferred - RN , CDIP, CCDS, or clinical degree **Education** + Required - associate's degree ... 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 in… more
- UTMB Health (Galveston, TX)
- …**New** **Hot** Business, Managerial & Finance UTMB Health Requisition # 2404547 ** Nurse Auditor ** **Minimum Qualifications:** RN designation with current ... Nurse Auditor - Revenue Cycle, Patient...patient care in hospital setting. **Licenses, Registrations, or Certifications:** RN designation with current Texas license required. **Job Summary/Description:**… 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 ... maximize client savings by reviewing medical bills from a nurse perspective, including appropriate billing, coding and treatment, fee...is part time 20-24 hours a week. Requirements + RN (or LPN) with active professional license or equivalent… more