• Nurse Auditor - Medical Bill…

    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 ... Join our team and maximize client savings by reviewing medical bills from a nurse perspective, including...within! + Opportunity to make a difference in reducing health care costs and increasing the value of … more
    Rising Medical Solutions (11/13/24)
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  • Diagnosis Related Group Clinical Validation…

    Elevance Health (Atlanta, GA)
    **Diagnosis Related Group Clinical Validation Auditor -** **Registered Nurse ** **Location:** This position will work a hybrid model (remote and office). Ideal ... of one of our PulsePoint locations. The **Diagnosis Related Group Clinical Validation Auditor ** is responsible for auditing inpatient medical records to ensure… more
    Elevance Health (11/08/24)
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  • Clinical Nurse Auditor , HEDIS…

    Providence (WA)
    …we must empower them._** **Providence Health Plan is calling a Clinical Nurse Auditor , HEDIS who will:** + Be responsible for conducting clinical quality ... + This posting is for multiple openings of a Nurse Auditor , HEDIS + This position is...including a retirement 401(k) Savings Plan with employer matching, health care benefits ( medical , dental, vision), life… more
    Providence (10/30/24)
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  • Revenue Integrity Nurse Auditor

    Trinity Health (Albany, NY)
    **Employment Type:** Full time **Shift:** Day Shift **Description:** **Revenue Integrity Nurse Auditor - Remote - St. Peter's Hospital - FT Days** If you are ... this could be your opportunity. Here at St. Peter's Health Partners, we care for more people in more...**Responsibilities** : + Conducts monthly internal charge audits (compares medical record to charges) to ensure charging integrity. +… more
    Trinity Health (11/27/24)
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  • 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 ... reimbursement to the health system from third party payers. Reports to the...regulations and trends in denials of services due to medical necessity or appropriateness of services. + Conducts compliance,… more
    Childrens Hospital of The King's Daughters (10/26/24)
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  • (RN) HCS-D, COS-C - Registered Nurse Coding…

    Northwell Health (Garden City, NY)
    …Coding Specialist-Diagnosis, COS-C Certificate for OASIS Specialist-Clinical. Conducts Home Health Resource Group (HHRG) Validation to ensure the diagnostic ... to the assignment can be substantiated by the documentation in the Medical Record. Job Responsibility + Audits and reviews Medicare/non-Medicare charts to ensure… more
    Northwell Health (09/02/24)
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  • Registered Nurse Coding Auditor

    Northwell Health (Port Jefferson, NY)
    …to the assignment can be substantiated by the documentation in the Medical Record. Job Responsibility 1.Leverages clinical expertise to identify and validate DRG ... and related experience. 2.Current License to practice as a Registered Professional Nurse in New York State required, plus specialized certifications as needed.… more
    Northwell Health (11/14/24)
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  • Concurrent Review Nurse -( Auditor

    InnovaCare (San Juan, PR)
    …daily, to the Utilization Management Inpatient Coordinator.14. Prepares and submits to the Health Services Department / UM Medical Care Manager a monthly report ... duties, weekly reports and/or relevant to the position as requested by the Health Services Department Inpatient Medical Care Manager.18. Documents the discharge… more
    InnovaCare (10/16/24)
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  • 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)
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  • 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 ... and revises better best practice within the department. The Intermediate Clinical Auditor Analyst reviews medical records, creates, maintains, and analyzes… more
    UPMC (11/01/24)
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  • 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 ... hours volunteering in our communities. As a Revenue Integrity Auditor RN with Parallon you can be a part...Parallon, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The… more
    HCA Healthcare (10/10/24)
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  • Coding Quality Auditor , HEDIS *Remote

    Providence (OR)
    …we know that to inspire and retain the best people, we must empower them._** **Providence Health Plan is calling a Coding Quality Auditor , HEDIS who will:** + Be ... HS Diploma or GED Equivalency + Licensure / Certification: Medical Assistant, Certified Nurse Assistant, or Licensed...including a retirement 401(k) Savings Plan with employer matching, health care benefits ( medical , dental, vision), life… more
    Providence (11/16/24)
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  • 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...environment. Additional Skills & Qualifications + Strong understanding of medical records/patient charts organization and terminology. + Detail-oriented and… more
    Actalent (11/28/24)
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  • Compliance Auditor , Intermediate (Hybrid…

    UPMC (Pittsburgh, PA)
    …Coder (CIC) + Certified Evaluation & Management Coder (CEMC) + Certified Professional Medical Auditor (CPMA) + Certified Professional Coder (CPC) + Certified ... Medical Coder (CMC) + ORRegistered Health Information...ORRegistered Health Information Administrator (RHIA) + Registered Health Information Technician (RHIT) + ORLicensed Professional Nurse more
    UPMC (10/11/24)
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  • Lead Clinical Documentation Auditor (CCDS…

    Vanderbilt University Medical Center (Nashville, TN)
    **Discover Vanderbilt University Medical Center:** Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery, and patient care, ... will be valued, your knowledge expanded, and your abilities challenged. Vanderbilt Health recognizes that diversity is essential for excellence and innovation. We… more
    Vanderbilt University Medical Center (11/22/24)
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  • RN-Charge Auditor

    Ascension Health (Austin, TX)
    …+ **Location: Austin, TX** **Benefits** Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match ... Coordinate payer denials and appeals, respond to insurance company requests for medical records, and perform medical record reviews. + Review … more
    Ascension Health (11/23/24)
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  • RN-Clin Documentation Auditor

    Ascension Health (Austin, TX)
    …travel to the area as needed)** **Benefits** Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans ... department, including performing concurrent and retrospective reviews of the medical records, utilizing evidence-based knowledge, protocols, and documentation criteria.… more
    Ascension Health (11/07/24)
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  • RN Clinical Documentation Auditor

    Ascension Health (Wichita, KS)
    **Details** + **Department:** Health Information Management + **Schedule:** Full-time, 8am-4:30pm Monday-Friday, off for Ascension Holidays + **Hospital:** Ascension ... travel to the area as needed **Benefits** Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans… more
    Ascension Health (11/02/24)
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  • RN Charge Auditor

    Ascension Health (Glendale, WI)
    …MUST reside in Wisconsin.** **Benefits** Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match ... Coordinate payer denials and appeals, respond to insurance company requests for medical records, and perform medical record reviews. + Review … more
    Ascension Health (10/17/24)
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  • Remote Auditor , Clinical Services - RN…

    Molina Healthcare (FL)
    …experience in case management, disease management or utilization management in managed care, medical or behavioral health settings. + Two years of clinical ... **KNOWLEDGE/SKILLS/ABILITIES** + Performs monthly auditing of registered nurse and other clinical functions in Utilization Management (UM), Case Management (CM),… more
    Molina Healthcare (11/28/24)
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