• Nurse Auditor / Revenue Cycle, FT,…

    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
    Omaha Children's Hospital (10/04/24)
    - Save Job - Related Jobs - Block Source
  • Revenue Integrity Nurse Auditor

    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
    Childrens Hospital of The King's Daughters (10/26/24)
    - Save Job - Related Jobs - Block Source
  • Nurse Auditor - Medical Bill Review…

    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
    Rising Medical Solutions (09/07/24)
    - Save Job - Related Jobs - Block Source
  • RN, Provider Clinical Compliance

    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
    Baystate Health (10/31/24)
    - Save Job - Related Jobs - Block Source
  • (RN) HCS-D, COS-C - Registered Nurse Coding…

    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
    Northwell Health (09/02/24)
    - Save Job - Related Jobs - Block Source
  • Compliance Auditor , Intermediate…

    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
    UPMC (10/11/24)
    - Save Job - Related Jobs - Block Source
  • Concurrent Review Nurse -( Auditor

    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
    InnovaCare (10/16/24)
    - Save Job - Related Jobs - Block Source
  • CDM Analyst RI Auditor

    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
    Chesapeake Regional Healthcare (10/26/24)
    - Save Job - Related Jobs - Block Source
  • Intermediate Clinical Auditor /Analyst, QA…

    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
    UPMC (11/01/24)
    - Save Job - Related Jobs - Block Source
  • Revenue Integrity Auditor RN

    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
    HCA Healthcare (10/10/24)
    - Save Job - Related Jobs - Block Source
  • Clinical Research Auditor

    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
    Actalent (10/29/24)
    - Save Job - Related Jobs - Block Source
  • Quality Lead Auditor (Hybrid - Wilmington,…

    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
    GE Vernova (10/23/24)
    - Save Job - Related Jobs - Block Source
  • Clinical Services Auditor (Remote)

    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
    Molina Healthcare (10/17/24)
    - Save Job - Related Jobs - Block Source
  • Lead Clinical Documentation Auditor (CCDS…

    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
    Vanderbilt University Medical Center (10/02/24)
    - Save Job - Related Jobs - Block Source
  • RN Charge Auditor

    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
    Ascension Health (10/17/24)
    - Save Job - Related Jobs - Block Source
  • Clinical Coding Appeals Nurse

    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
    R1 RCM (10/25/24)
    - Save Job - Related Jobs - Block Source
  • Clinical Research Monitoring Specialist Senior…

    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
    University of Pennsylvania (10/03/24)
    - Save Job - Related Jobs - Block Source
  • HEDIS Quality Management Consultant

    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
    Actalent (10/22/24)
    - Save Job - Related Jobs - Block Source
  • Quality Improvement (RN) - Maternity (OB/GYN)

    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
    Molina Healthcare (10/20/24)
    - Save Job - Related Jobs - Block Source
  • Accreditation and ISO Coordinator

    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
    Carle (09/18/24)
    - Save Job - Related Jobs - Block Source