- Saint Francis Health System (Tulsa, OK)
- …**to login and apply.** Full Time Days Job Summary: The Compliance Nurse Auditor assists with and supports ... Registration and/or Certification: Valid multi-state or State of Oklahoma Registered Nurse License. Work Experience: Minimum 3 years of healthcare compliance… 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
- Elevance Health (Atlanta, GA)
- ** 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
- Northwell Health (Garden City, NY)
- …Medicare/non-Medicare charts to ensure that proper standards are maintained in compliance with Federal and State regulations. 5.Applies coding rules and regulations ... the validation review process. 6.Reviews codes on Medicare/non-Medicare charts for compliance to rules and conventions. 7.Communicates DRG changes and rationale to… 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 ... Coordinates, retrieves, and performs medical record audits to determine provider compliance with established AHCCCS standards for documentation in conjunction with… more
- Stanford Health Care (Palo Alto, CA)
- …is a Stanford Health Care job.** **A Brief Overview** The Charge Auditor performs auditing activities, including complex cases that require extensive research, ... interpretation and application of laws and regulations. Charge Auditor evaluates the adequacy and effectiveness of internal and operational controls designed to… 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 ... Conduct on-site reviews at provider offices to assess record quality and compliance with documentation standards. + Prepare reports summarizing findings and provide… more
- UNC Health Care (Chapel Hill, NC)
- …the state to train and shadow round with Clinical Documentation Specialists. The CDS auditor provides elbow to elbow support during training and education as well as ... all patients. Educates on proper creation of provider compliant queries. 8. Ensures compliance with third party and State and Federal regulations. 9. Audits CDS… more
- Baylor Scott & White Health (Dallas, TX)
- …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 ... audit tasks in clinical departments/functions. + Evaluate clinical documentation for compliance , meeting all regulations stipulated by federal and state agencies as… more
- Centene Corporation (Jefferson City, MO)
- …staff at the health plan in the use of audit process and tools + Facilitate compliance with the auditing process + Act as a consultant related to system auditing to ... RESIDE IN MISSOURI **Ideal candidate will be a Licensed Practical Nurse (LPN) with auditing experience.** **Education/Experience:** Bachelor's degree in related… more
- Molina Healthcare (Savannah, GA)
- …requirements for the health plan(s) they support. Identifies risk and non- compliance , issues corrective action, and actively manages the corrective action process ... **Preferred Qualifications** * Certified Credentialing Specialist (CCS), Licensed Practical Nurse (LPN), Licensed Vocational Nurse (LVN), Certified Clinical… more
- University of Southern California (Alhambra, CA)
- …to evaluate department charge processes to improve charge capture and coding compliance . The Senior RI Specialist also coordinates with Keck Medical Center of ... USC Administration, IS, Compliance , Clinical Informatics and Integration personnel on technology projects...and provides leadership by providing direction to the revenue auditor team to all entities of Keck Medical Center… more
- Dignity Health (Rancho Cordova, CA)
- …ensuring all relevant documentation is presented to the Medical Director. The nurse must meticulously track and document all appeal activities, guaranteeing timely ... resolution in compliance with federal, state, and local regulations, including CMS...maintaining a detailed activity log for leadership review. The nurse will actively participate in audits, identifying and implementing… more
- GE Vernova (Wilmington, NC)
- …resources. + Maintain and develop applications/software solutions for continued compliance and improvements including administration and deployment of software ... willingness to complete qualification and certification as a Lead Auditor . + Availability and willingness for periodic travel to...access to Health Coach from GE Vernova, a 24/7 nurse -based resource; and access to the Employee Assistance Program,… more
- St. Luke's University Health Network (Allentown, PA)
- …coding determination made by the government or commercial payors, or their auditor representative. + Facilitate clinical chart reviews to assist with supporting ... + Participate in Administrative Law Judge (ALJ) hearings and/or formal meetings with auditor or payor representatives in defense of coding appeals, as needed. +… more
- Trinity Health (Livonia, MI)
- …to intra-departmental Revenue Integrity colleagues including areas of opportunity. Assist Nurse Auditor and/or other stakeholders with denial related charge ... coding credentials _and/or Licensed Vocational Nurse / Licensed Practical Nurse licensure_ is required. CHC (Healthcare Compliance Certification) prefered… more
- GE Vernova (Clearwater, FL)
- **Job Description Summary** To ensure environmental compliance via recordkeeping, reporting with program implementation and management. Additionally, develop and ... Lead you will: + Be responsible for supporting air, waste and water compliance for our Clearwater and other Power Transmission manufacturing sites + Support… more
- GE Vernova (Schenectady, NY)
- …- Rigorously execute the supplier evaluation process, including quality & compliance audits / assessments to ensure that only appropriately qualified suppliers ... + Provide technical guidance to suppliers to assure product/process compliance with engineering drawings and specifications + Work closely...such as from ASTM, ASME etc + ISO Lead auditor certified by 3rd party registrar or accepted internal… more
- HCA Healthcare (San Antonio, TX)
- …true discrepancy and complete incident reports as required. You will review RX Auditor report and generate investigation reports for nurse managers/directors to ... hospital personnel politely and appropriately. You will perform and monitor compliance for quality control and performance improvement functions as assigned. You… more
- GE Aerospace (Charleston, WV)
- …is also responsible for providing leadership in the area of maintaining compliance with the Cost Accounting Standards (CAS) and Federal Acquisition Regulations ... the wider Government Accounting team to achieve team and business compliance objectives. **Job Description** **Roles and Responsibilities** The Senior Government… more
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