- Omaha Children's Hospital (Omaha, NE)
- …and provides education/training regarding proper billing requirements. The Nurse Auditor will work collaboratively within Revenue Cycle, Compliance and ... 3 days post discharge to ensure accuracy and in compliance with regulatory requirements, hospital and system policies and...to accurately support billing and payment. In addition, the Nurse Auditor will complete requests for account… 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 ... timely manner. + Prepares trend and other reports for compliance audits and charge processes. + Serves as a...CERTIFICATIONS + Current Virginia state license as a Registered Nurse or Registered Nurse holding a valid… 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 ... team and maximize client savings by reviewing medical bills from a nurse perspective, including appropriate billing, coding and treatment, fee schedule compliance… more
- Baystate Health (Springfield, MA)
- …group in the region is looking for an experience **RN, Provider** **Clinical Compliance Auditor ** to join the Baystate Medical Practice Revenue Integrity Team ... )** Under the direct supervision of the Manager, the **RN, Provider** **Clinical Compliance Auditor ** for Baystate Medical Practices, reviews and responds to… more
- Northwell Health (Garden City, NY)
- …reviews Medicare/non-Medicare charts to ensure that proper standards are maintained in compliance with Federal and State regulations. + Applies coding rules and ... the validation review process. + Reviews codes on Medicare/non-Medicare charts for compliance to rules and conventions. + Instructs professional staff in code… more
- UPMC (Pittsburgh, PA)
- **UPMC Corporate Finance is hiring a full-time Compliance Auditor , Intermediate. This position will be based out of Forbes Tower in Pittsburgh, PA. This position ... claims processing, data collection, and quality reporting. + Conduct audits on other compliance related topics as determined to evaluate compliance with the… 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 ... ICT and health assessments. Staff will notify supervisors of any processes not in compliance with the Plan's SNP policies and MOC requirements. Clinical staff who do… 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 ... and advising the billing staff of appropriate HCPCS codes and modifiers. The Nurse Auditor / Revenue Integrity/ CDM Analyst works directly with revenue producing… 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 - ... Steel Tower, however, this role may work remotely. The Intermediate Clinical Auditor /Analyst is an integral part of the Quality Assurance and Operational Integrity… 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 ... colleagues invested over 156,000 hours volunteering in our communities. As a Revenue Integrity Auditor RN with Parallon you can be a part of an organization that is… more
- Actalent (Philadelphia, PA)
- …Essential 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...human subjects clinical research and the principles of conducting compliance oversight. Responsibilities + Conduct thorough audits of clinical… more
- GE Vernova (Wilmington, NC)
- **Job Description Summary** The Nuclear Programs Quality Lead Auditor will be responsible for managing internal and external quality assessments to ensure and ... capabilities to comply with industry standards and regulations. The Quality Lead Auditor has working knowledge of applicable industry regulations and standards; has… 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), ... (HM), and/or Disease Management (DM). + Monitors key clinical staff for compliance with NCQA, CMS, State and Federal requirements. May also perform non-clinical… more
- Vanderbilt University Medical Center (Nashville, TN)
- …Identifies areas for improvement for clinical documentation workflow, clinical query compliance , data integrity and training. * Reviews medical records to determine ... terminology and documentation in an office, or surgical setting. * Compliance (Advanced): Understanding the rules, regulations, sanctions and other statutory… more
- Ascension Health (Glendale, WI)
- **Details** + **Department: Recovery Audit Compliance ** + **Schedule: Full Time, Days, (M-F 8a-5p - some flexibility)** + **Hospital: AW Glendale Corporate Office** ... savings potential. **Requirements** Licensure / Certification / Registration: + Registered Nurse credentialed from the Wisconsin Board of Nursing obtained prior to… more
- R1 RCM (Chicago, IL)
- …AI, intelligent automation, and workflow orchestration. As our **Clinical Coding Appeals Nurse ** , you will help review and interpret medical records to draft ... you will experience working as a Clinical Coding Appeals Nurse :** + Review and interpret medical records to appeal...a Clinical Validation Review by an insurer or third-party auditor . + Draft appeal letters that are well-written, logically… more
- University of Pennsylvania (Philadelphia, PA)
- …as well as assisting with corrective actions and training related to research compliance , quality control and quality assurance. The monitor/ auditor will follow ... field preferred. Minimum of seven years of experience as a clinical research monitor/ auditor , research nurse or research coordinator with at least three years'… more
- Actalent (Des Moines, IA)
- …records, performing claims research, preparing medical records for the NCQA HEDIS Auditor , etc. Abstracts medical record data from practitioner's files to support ... company's electronic HEDIS application Ensure Health & Care Management are in compliance with HEDIS audit and technical specification standards Participate in the… more
- Molina Healthcare (Ypsilanti, MI)
- …Association** + Certified Professional in Health Quality (CPHQ) + Certified HEDIS Compliance Auditor (CHCA) + Registered Health Information Technician (RHIT), or ... **JOB DESCRIPTION** _For this position we are seeking a (RN) Registered Nurse who must live and have a current active unrestricted RN license in the state of MI_… more
- Carle (Urbana, IL)
- …education, auditing, and corrective action planning required to meet regulatory compliance and accreditation objectives within the Quality Management System of GPA ... departments to develop their understanding and accountability for regulatory compliance . Coordinates the development of policies/procedures and strategies to ensure… more
Related Job Searches:
Auditor,
Compliance,
Compliance Auditor,
Compliance Nurse,
Nurse,
Nurse Auditor