- Ascension (Austin, TX)
- …additional specifics.Responsibilities Develop, implement, and have oversight over the Clinical Documentation Integrity (CDI) audit plan, utilize audit findings to ... staff feedback; implement and facilitate this training with CDI staff, physicians, clinical and ancillary staff to improve the overall quality and completeness of… 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 ... + This posting is for multiple openings of a Nurse Auditor , HEDIS + This position is...position include:** + Degree in Nursing + Oregon Registered Nurse License + 5+ years clinical experience… more
- Omaha Children's Hospital (Omaha, NE)
- …Auditor will complete requests for account audits by third party agencies. The Nurse Auditor position ensures clinical documentation supports all patient ... for payment, and provides education/training regarding proper billing requirements. The Nurse Auditor will work collaboratively within Revenue Cycle, Compliance… 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 ... Pittsburgh's US Steel Tower, however, this role may work remotely. The Intermediate Clinical Auditor /Analyst is an integral part of the Quality Assurance and… 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
- 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
- Actalent (Philadelphia, PA)
- …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 experienced Clinical Research Auditor with a minimum of 7 years of … 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...neuro, rehab, or ER procedures + 3-5 years of clinical experience in acute care, surgery and/or orthopedic +… more
- Elevance Health (Denver, CO)
- **Diagnosis Related Group Clinical Validation Auditor ** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live ... 50 miles of one of our PulsePoint locations. The **Diagnosis Related Group Clinical Validation Auditor ** is responsible for auditing inpatient medical records to… more
- Northwell Health (Garden City, NY)
- …a HCS-D - Home Care Coding Specialist-Diagnosis, COS-C Certificate for OASIS Specialist- Clinical . Conducts Home Health Resource Group (HHRG) Validation to ensure the ... + Instructs professional staff in code changes, as needed. + Assists clinical staff and nursing supervisors in providing appropriate documentation in the Medical… 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 ... compliance with the Plan's SNP policies and MOC requirements. Clinical staff who do not complete the required annual...complete the required annual training may not perform their clinical duties until the training is completes\. ESSENTIAL DUTIES… 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 ... billing staff of appropriate HCPCS codes and modifiers. The Nurse Auditor / Revenue Integrity/ CDM Analyst works...to communicate effectively verbally and in written format to clinical and non- clinical staff and individuals +… more
- Molina Healthcare (Jackson, MS)
- **KNOWLEDGE/SKILLS/ABILITIES** + Performs monthly auditing of registered nurse and other clinical functions in Utilization Management (UM), Case Management (CM), ... Team (MAT), Health Management (HM), and/or Disease Management (DM). + Monitors key clinical staff for compliance with NCQA, CMS, State and Federal requirements. May… more
- Ascension Health (Wichita, KS)
- …specifics._ **Responsibilities** Develop, implement, and has oversight over the Clinical Documentation Integrity (CDI) audit plan, utilizing audit findings to ... implement and facilitate this training with CDI staff, physicians, clinical and ancillary staff to improve the overall quality...date or job transfer date required. + Licensed Registered Nurse credentialed from the Kansas Board of Nursing obtained… 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 ... hours volunteering in our communities. As a Revenue Integrity Auditor RN with Parallon you can be a part...to obtain missing documentation when applicable. Ability to associate clinical and coding information to national and local coverage… more
- Providence (WA)
- …in AK, WA, MT, OR, CA, TX or NM are encouraged to apply.** The Nurse Auditor is responsible for providing patient focused, standardized, compliant revenue cycle ... 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
- Ascension Health (Austin, TX)
- …specifics._ **Responsibilities** Develop, implement, and have oversight over the Clinical Documentation Integrity (CDI) audit plan, utilize audit findings to ... implement and facilitate this training with CDI staff, physicians, clinical and ancillary staff to improve the overall quality...hire date or job transfer date required. + Registered Nurse credentialed from the Texas Board of Nursing obtained… more
- Ascension Health (Glendale, WI)
- …accuracy of billing through verification of coding, billing and supporting clinical documentation. + Coordinate all activities associated with insurance carrier ... savings potential. **Requirements** Licensure / Certification / Registration: + Registered Nurse credentialed from the Wisconsin Board of Nursing obtained prior to… more
- R1 RCM (Chicago, IL)
- …encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Clinical Coding Appeals Nurse ** , you will help review and ... position. **Here's what you will experience working as a Clinical Coding Appeals Nurse :** + Review and...Clinical Validation Review by an insurer or third-party auditor . + Draft appeal letters that are well-written, logically… 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
