- Elevance Health (Richmond, VA)
- ** Nurse Auditor Senior - Payment Integrity Complex and Clinical Audit** **Location:** This role enables associates to work virtually full-time, with the ... determined to recover, eliminate and prevent unnecessary medical-expense spending. The ** Nurse Audit Senior** will be responsible for identifying, monitoring, and… more
- 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
- Saint Francis Health System (Tulsa, OK)
- …**to login and apply.** Full Time Days Job Summary: The Compliance Nurse Auditor assists with and supports the compliance program activities ... within Saint Francis Health System (SFHS). This role supports clinical coding and billing audit functions as well as the performance of routine and complex audits,… 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 ... focus audits and reports findings. + Serves as a clinical resource for coding / denial management and customer...CERTIFICATIONS + Current Virginia state license as a Registered Nurse or Registered Nurse holding a valid… 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 ... accommodation is granted as required by law. The **Diagnosis Related Group Clinical Validation Auditor -RN** is responsible for auditing inpatient medical records… more
- Intermountain Health (Murray, UT)
- **Job Description:** This position utilizes clinical expertise, expert coding knowledge and critical thinking skills to work collaboratively with internal compliance ... Medicare Cost Report. **Join a nationally recognized Transplant Unit where your clinical expertise and attention to detail directly support exceptional patient care.… 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...(2) two years of relevant work experience. + Registered Nurse License. As a health care system committed to… 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
- Banner Health (AZ)
- …employment settings by including remote and hybrid opportunities. As a **Licensed Practical Nurse (LPN)** for **Banner Health Plans** , you will be an integral part ... . This assignment-based role focuses on independent chart review and clinical assessment. **Key Responsibilities** : + Independently review patient medical charts… more
- Northwell Health (Garden City, NY)
- …HCS-D - Home Care Coding Specialist-Diagnosis, COS-C Certificate for OASIS Specialist- Clinical . Remote position Job Responsibility 1.Leverages clinical expertise ... and related experience. 2.Current License to practice as a Registered Professional Nurse in New York State required, plus specialized certifications as needed.… more
- Adecco US, Inc. (Bradenton, FL)
- …education and training to healthcare providers. **Responsibilities of the Coding Auditor and Educator:** . Facilitates optimal clinical documentation performance ... Healthcare & Life Sciences is looking for a **Coding Auditor and Educator** for our client in **Bradenton, FL!**...dual role in promoting the quality and accuracy of clinical documentation by providing education and training to healthcare… more
- Insight Global (South Jordan, UT)
- …criteria, and coding terminology. Expert coding knowledge (DRG & ICD-10) Registered Nurse RN (must be inpatient) WITH coding/ clinical documentation certification ... Job Description Insight Global is seeking a DRG Validation Auditor for one of our clients to sit 100%...in clinical documentation) OR IF NOT A NURSE : Degree in RHIM, RHIA, RHIT with medical coding… more
- Trinity Health (Fresno, CA)
- …Day Shift **Description:** Reporting to the Nurse Manager*, Cath Lab, the Nurse Auditor performs thorough chart review of Electronic Medical Records (EMR) ... education is required. 2. Current licensure as a Registered Nurse (RN) with the state of California is required....state of California is required. 3. Four (4) years clinical experience in cardiovascular service environment is required. 4.… more
- US Tech Solutions (Newark, NJ)
- …months contract with potential extends or Convert** **Job Description:** + The HEDIS Nurse Auditor is responsible for conducting quality audits related to state ... to identify trends and facilitate quality improvement initiatives. + Assist with clinical studies, quality projects, and audits. + Lead and coordinate Corrective… more
- Centene Corporation (Jefferson City, MO)
- …the auditing of corporate, health plan, and specialty company staff related to clinical systems entry and/or processes + Develop and maintain the audit process and ... audit errors + Coordinate auditing outcomes and system maintenance with the Sr. + Clinical Systems Specialist to resolve or enhance clinical systems + Performs… more
- Molina Healthcare (Macon, GA)
- …Credentialing Specialist (CCS), Licensed Practical Nurse (LPN), Licensed Vocational Nurse (LVN), Certified Clinical Coder (CCD), Certified Medical Audit ... Specialists (CMAS), Certified Professional in Healthcare Management (CPHM) and/or other health care certification/licensure. If licensed, license must be active and unrestricted in state of practice. To all current Molina employees: If you are interested in… more
- University of Washington (Seattle, WA)
- …Medicine's Patient Financial Services Department** has an outstanding opportunity for a ** Clinical Appeals and Disputes Nurse .** **WORK SCHEDULE** + 100% FTE ... + 100% Remote + Days **POSITION HIGHLIGHTS** The Clinical Appeals and Disputes Nurse ensures that...at least one of the following: certified healthcare chart auditor , certified professional in utilization review (or utilization management… more
- SSM Health (MO)
- …Summary:** Performs as a vital member of the interdisciplinary care team member, an auditor , and an educator ensuring medical records are complete and clinical ... and electronic health record charts that accurately capture the clinical picture. **Job Responsibilities and Requirements:** PRIMARY RESPONSIBILITIES + Reviews… more
- St. Luke's University Health Network (Allentown, PA)
- …or coding determination made by the government or commercial payors, or their auditor representative. + Facilitate clinical chart reviews to assist with ... regardless of a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and… more
- University of Southern California (Alhambra, CA)
- As the center of clinical charge capture, the Revenue Integrity (RI) Specialist provides leadership to the daily CDM maintenance workflow between the various ... coordinates with Keck Medical Center of USC Administration, IS, Compliance, Clinical Informatics and Integration personnel on technology projects impacting charge… more