- TEKsystems (Chesapeake, VA)
- Description Summary: With direction from the Patient Financial Services Director, the Nurse Auditor / Revenue Integrity/CDM Analyst is responsible for performing ... and advising the billing staff of appropriate HCPCS codes and modifiers. The Nurse Auditor / Revenue Integrity/CDM Analyst works directly with revenue producing… more
- Elevance Health (Seattle, WA)
- **Diagnosis Related Group Clinical Validation Auditor -** **Registered Nurse ** **Location:** This position will work a hybrid model (remote and office). Ideal ... one of our PulsePoint locations. The **Diagnosis Related Group Clinical Validation Auditor ** is responsible for auditing inpatient medical records to ensure clinical… more
- Molina Healthcare (Reno, NV)
- …Time Zone hours** **KNOWLEDGE/SKILLS/ABILITIES** + Performs monthly auditing of registered nurse and other clinical functions in Utilization Management (UM), Case ... + Maintains member/provider confidentiality in compliance with the Health Insurance Portability and Accountability Act (HIPAA) and professionalism with all… more
- Dignity Health (Phoenix, AZ)
- …American Association of Medical Audit Specialists (AAMAS) and National Commission on Insurance Guidelines and **Preferred** **Pay Range** $33.60 - $48.73 /hour We ... are an equal opportunity/affirmative action employer. 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
- Humana (Columbus, OH)
- …of our caring community and help us put health first** The Compliance Nurse Auditor reviews utilization management activities and documentation to ensure ... and detect fraud, waste, and abuse. The RN Compliance Nurse 2, Quality Assurance Audit ensures mandatory reporting is...past 3 years + Experience as a Utilization Management Auditor + Health Plan experience working with large carriers… more
- Community Health Systems (Sarasota, FL)
- (Full-Time, Remote) The Clinical Review Auditor is a professionally licensed nurse /LPN who is responsible for effectively managing the denial/appeal process via ... care delivered to patients in a dynamic changing environment. As an Clinical Review Auditor at Community Health Systems, you'll play a vital role in supporting our… more
- Actalent (Philadelphia, PA)
- …Skills + Minimum of 7 years of clinical research experience as a monitor/ auditor , research nurse , research coordinator, regulatory affairs, quality control and ... Research AuditorJob Description We are seeking a highly experienced Clinical Research Auditor to join our team. The ideal candidate will have extensive experience… more
- Molina Healthcare (San Francisco, CA)
- …business hours.** **KNOWLEDGE/SKILLS/ABILITIES** + Performs monthly auditing of registered nurse and other clinical functions in Utilization Management (UM), Case ... use. + Maintains member/provider confidentiality in compliance with the Health Insurance Portability and Accountability Act (HIPAA) and professionalism with all… more
- Centene Corporation (Tallahassee, FL)
- …Licensed Clinical Social Worker (LCSW), Licensed Mental Health Counselor (LMHC), Registered Nurse (RN), or Licensed Psychologist (Ph.D. or Psy.D.) This supports our ... Centene offers a comprehensive benefits package including: competitive pay, health insurance , 401K and stock purchase plans, tuition reimbursement, paid time off… more
- Ascension Health (Wichita, KS)
- …to the area as needed **Benefits** Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans Long-term ... obtained prior to hire date or job transfer date required. + Licensed Registered Nurse credentialed from the Kansas Board of Nursing obtained prior to hire date or… more
- Baystate Health (Springfield, MA)
- …OF WORKING WITH BAYSTATE!** + Excellent Compensation High-quality, low-cost medical, dental and vision insurance + Generous PTO - up to 25 days in the first year, ... and financial health + Pet, home, auto and personal insurance + Life insurance + Reimbursement for...be applicable to this role.** **Summary:** Reports to the Nurse Manager but daily activities are coordinated by the… more
- GE Vernova (Greenville, SC)
- …standards and codes such as from ASTM, ASME, EN etc + ISO Lead auditor certified by 3rd party registrar or accepted internal GE training/certification program + ... and prescription drug coverage; access to a Health Coach, a 24/7 nurse -based resource; and access to the Employee Assistance Program, providing 24/7 confidential… more
- GE Vernova (Schenectady, NY)
- …root cause analysis) and quality management systems such as ISO 9001:2015 lead auditor training. + You are someone who is proactive, not easily discouraged, humble, ... and prescription drug coverage; access to a Health Coach, a 24/7 nurse -based resource; and access to the Employee Assistance Program, providing 24/7 confidential… more
- HCA Healthcare (Live Oak, TX)
- …true discrepancy and complete incident reports as required. You will review RX Auditor report and generate investigation reports for nurse managers/directors to ... plans (accident, critical illness, hospital indemnity), auto and home insurance , identity theft protection, legal counseling, long-term care coverage, moving… more
- GE Vernova (Greenville, SC)
- …root cause analysis) and quality management systems such as ISO 9001:2015) lead auditor training. + You are someone who is proactive, not easily discouraged, humble, ... and prescription drug coverage; access to a Health Coach, a 24/7 nurse -based resource; and access to the Employee Assistance Program, providing 24/7 confidential… more
- GE Vernova (Schenectady, NY)
- …standards and codes such as from ASTM, ASME etc + ISO Lead auditor certified by 3rd party registrar or accepted internal GE training/certification program + ... and prescription drug coverage; access to a Health Coach, a 24/7 nurse -based resource; and access to the Employee Assistance Program, providing 24/7 confidential… more
- GE Vernova (Wilmington, NC)
- …+ Strong analytical and problem-solving skills. + Previous or Current Quality Lead Auditor certification. + 4 year's experience working in a Nuclear Quality Role. ... and prescription drug coverage; access to a Health Coach, a 24/7 nurse -based resource; and access to the Employee Assistance Program, providing 24/7 confidential… 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 ... plans (accident, critical illness, hospital indemnity), auto and home insurance , identity theft protection, legal counseling, long-term care coverage, moving… more
- CVS Health (Columbus, OH)
- …Ability to travel for business needs. **Preferred Qualifications:** Registered Nurse (RN) Previous leadership experience. AAPC Coding Certification - Certified ... Professional Biller (CPB), Certified Professional Medical Auditor (CPMA), Certified Outpatient Coder (COC), Certified Risk Adjustment Coder (CRC) Licensed Clinical… more