• 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 ... AND/OR CERTIFICATIONS + Current Virginia state license as a Registered Nurse or Registered Nurse holding a valid Compact State license. + Certified Professional… more
    Childrens Hospital of The King's Daughters (10/23/25)
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  • Nurse Auditor Senior - Payment…

    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
    Elevance Health (12/24/25)
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  • Compliance Nurse Auditor

    Saint Francis Health System (Tulsa, OK)
    …**to login and apply.** Full Time Days Job Summary: The Compliance Nurse Auditor assists with and supports the compliance program activities ... Registration and/or Certification: Valid multi-state or State of Oklahoma Registered Nurse License. Work Experience: Minimum 3 years of healthcare compliance… more
    Saint Francis Health System (12/23/25)
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  • Cardiovascular Services RN Auditor Full…

    Trinity Health (Fresno, CA)
    …Day Shift **Description:** Reporting to the Nurse Manager*, Cath Lab, the Nurse Auditor performs thorough chart review of Electronic Medical Records (EMR) ... of equivalent experience and education is required. 2. Current licensure as a Registered Nurse (RN) with the state of California is required. 3. Four (4) years… more
    Trinity Health (12/08/25)
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  • HEDIS RN - Quality Auditor

    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 ... experience, preferably in the healthcare industry. + **Active New Jersey Registered Nurse (RN) License required.** **Skills:** + Knowledge of managed care principles… more
    US Tech Solutions (11/20/25)
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  • (RN) Registered Nurse Coding Auditor

    Northwell Health (Garden City, NY)
    …and related experience. 2.Current License to practice as a Registered Professional Nurse in New York State required, plus specialized certifications as needed. ... *Additional Salary Detail The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the… more
    Northwell Health (12/20/25)
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  • Health Plans Licensed Practical Nurse LPN…

    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 ... of the **Health Plan Medical Management Team** . This assignment-based role focuses on independent chart review and clinical assessment. **Key Responsibilities** : + Independently review patient medical charts to assess whether the care provided may have… more
    Banner Health (11/27/25)
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  • Charge Specialist - RIO (Remote)

    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 ... RHIA, RHIT, CCS, CPC/COC or other coding credentials _and/or Licensed Vocational Nurse / Licensed Practical Nurse licensure_ is required. CHC (Healthcare… more
    Trinity Health (12/16/25)
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  • LPN Hospice Scheduler

    BJC HealthCare (St. Louis, MO)
    …collaborating within a team setting? BJC Home Care is looking for an licensed practical nurse Scheduler, auditor and field visits to assist our patients and our ... within the scope of practice for the Licensed Practical Nurse . + Under the direction of the Registered ...Nurse . + Under the direction of the Registered Nurse , provides patient teaching and discharge planning. Participates in… more
    BJC HealthCare (11/26/25)
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  • Coding Quality Auditor , HEDIS *Remote…

    Providence (CA)
    …must empower them._** **Providence Health Plan is calling a Coding Quality Auditor , HEDIS who will:** + Be responsible for conducting clinical quality ... Seasonal Role:_** + **This posting is for multiple openings of a Coding Quality Auditor , HEDIS** + **This position is affiliated with Providence Health Plan and will… more
    Providence (12/04/25)
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  • Diagnosis Related Group Clinical Validation…

    Elevance Health (Los Angeles, CA)
    **Diagnosis Related Group Clinical Validation Auditor -RN (CDI, MS-DRG, AP-DRG and APR-DRG)** **Virtual:** This role enables associates to work virtually full-time, ... granted as required by law. The **Diagnosis Related Group Clinical Validation Auditor ** is responsible for auditing inpatient medical records to ensure clinical… more
    Elevance Health (12/20/25)
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  • Revenue Integrity Charge Auditor (Remote)

    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
    Stanford Health Care (12/10/25)
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  • DRG Auditor - February Class

    Insight Global (South Jordan, UT)
    Job Description Insight Global is seeking a DRG Validation Auditor for one of our clients to sit 100% remote. This person should have an extensive background in ... and coding terminology. Expert coding knowledge (DRG & ICD-10) Registered Nurse RN (must be inpatient) WITH coding/clinical documentation certification (2 years… more
    Insight Global (12/24/25)
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  • Clinical Documentation Specialist Auditor

    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 ... (American Academy of Professional Coders) certification - RN (Registered Nurse ) license - LPN (Licensed Practical Nurse )...(Registered Nurse ) license - LPN (Licensed Practical Nurse ) license - Advance Practice Provider (NP or PA)… more
    UNC Health Care (10/28/25)
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  • Clinical Auditor RN - Hybrid

    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 ... work experience. + At least (2) two years of relevant work experience. + Registered Nurse License. As a health care system committed to improving the health of those… more
    Baylor Scott & White Health (12/21/25)
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  • Medical Management Auditor

    Centene Corporation (Jefferson City, MO)
    …RESIDE IN MISSOURI **Ideal candidate will be a Licensed Practical Nurse (LPN) with auditing experience.** **Education/Experience:** Bachelor's degree in related ... Mental Health Counselor (LMHC), Licensed Professional Counselor (LPC), Registered Nurse (RN), or Licensed Practical Nurse (LPN)...(LPC), Registered Nurse (RN), or Licensed Practical Nurse (LPN) Pay Range: $55,100.00 - $99,000.00 per year… more
    Centene Corporation (12/05/25)
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  • Senior Auditor , Delegation Oversight

    Molina Healthcare (Savannah, GA)
    …**Preferred Qualifications** * Certified Credentialing Specialist (CCS), Licensed Practical Nurse (LPN), Licensed Vocational Nurse (LVN), Certified Clinical ... Coder (CCD), Certified Medical Audit Specialists (CMAS), Certified Professional in Healthcare Management (CPHM) and/or other health care certification/licensure. If licensed, license must be active and unrestricted in state of practice. To all current Molina… more
    Molina Healthcare (12/17/25)
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  • Coding Investigator Auditor

    Health Care Service Corporation (Tulsa, OK)
    …**Organizational skills and prioritization skills** **Preferred Job Qualifications:** **Registered Nurse (RN) with unrestricted license in state.** **Certified Coder ... preferred** **3 plus years of claim adjudication/payment integrity** **3 years clinical experience** **This is a Telecommute (Remote) role: Must reside within 250 miles of the office or anywhere within the posted state.** \#LI-Remote \#LI-DP1 *CA **Are you… more
    Health Care Service Corporation (12/19/25)
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  • Clinical Appeals and Disputes Nurse

    University of Washington (Seattle, WA)
    …Services Department** has an outstanding opportunity for a **Clinical Appeals and Disputes Nurse .** **WORK SCHEDULE** + 100% FTE + 100% Remote + Days **POSITION ... HIGHLIGHTS** The Clinical Appeals and Disputes Nurse ensures that payers are prepared to reimburse the...at least one of the following: certified healthcare chart auditor , certified professional in utilization review (or utilization management… more
    University of Washington (12/19/25)
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  • Operations Associate Cardiac Monitor Tech, Part…

    Baystate Health (Springfield, MA)
    …incentive payments that may be applicable to this role.** **Summary:** **Reports to the Nurse Manager but daily activities are coordinated by the charge nurse . ... required telemetry training course.** **Summary** : Reports to the Nurse Manager, but daily activities are coordinated by the...C Word, OA Gold, SMS, CIS, Premise, BMD, PCM Auditor , People Soft and Staples, and Kronos access if… more
    Baystate Health (12/23/25)
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