- UnitedHealth Group (Minneapolis, MN)
- …you may be interested in. Required Qualifications: Associate's Degree (or higher) Unrestricted RN ( Registered Nurse ) license CCS/CIC or willing to obtain ... Connecting. Growing together . In this position as a Coding & Clinical Auditor / DRG Specialist RN , you will apply your expert knowledge of the MS-DRG and… more
- Elevance Health (St. Paul, MN)
- …Possibilities. Make an Extraordinary Impact. Title : Diagnosis Related Group Clinical Validation Auditor - RN (CDI, MS-DRG, AP-DRG and APR-DRG) **Virtual: ** _ ?_ ... reside within a commuting distance from an office. The DRG Coding Auditor is responsible for auditing inpatient medical records and generating high quality… more
- Robert Half (Boston, MA)
- …Ability to travel locally as needed Strong analytical, organizational, and communication skills RN ( Registered Nurse ) Experience working in a Program ... Description Job Title: Medical Claims Auditor - RN Auditor Location: Massachusetts - 90% Remote Job Type: 1 Year Contract - Potential for Perm Hire Hours: 40… more
- CVS Health (Phoenix, AZ)
- …rater reliability and scoring guidelines. Participates in QM meetings. Required Qualifications Active RN ( Registered Nurse ) or LPN (Licensed Practical ... with heart, each and every day. Position Summary The Healthcare Quality Management Auditor participates in the development and ongoing implementation of QM ( quality… more
- BJC HealthCare (St. Louis, MO)
- …for the Licensed Practical Nurse . Under the direction of the Registered Nurse , provides patient teaching and discharge planning. Participates in professional ... BJC Home Care is looking for an licensed practical nurse Scheduler, auditor and field visits to...utilizing the nursing process, under the supervision of the RN . Responsibilities Implements treatments and procedures within the scope… more
- Catholic Health Initiatives (Little Rock, AR)
- …all things quality and risk for the value hub. Through Risk Management/ Auditor Manager, implements a risk adjustment coding department in appropriate Arkansas and ... and guidelines for these new processes. Support the Risk Auditor Manager of closely working with the HCC Risk...Job Requirements Bachelors Degree in Nursing required Current, unencumbered RN license in primary state of residence with ability… more
- Molina Healthcare (Troy, MI)
- …Medicaid managed care Certified Professional in Health Quality (CPHQ) Nursing License ( RN may be preferred for specific roles) Certified HEDIS Compliance Auditor ... (CHCA) To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing Molina Healthcare offers a competitive benefits and compensation package Molina Healthcare is an Equal Opportunity… more
- Commonwealth Care Alliance (Boston, MA)
- …Professional Coder (CPC) Certified Inpatient Coder (CIC) Certified Professional Medical Auditor (CPMA) Desired Education (nice to have): Masters Degree Required ... record, (if applicable)), an OIG Report and verification of a valid MA/ RN license (if applicable). Commonwealth Care Alliance is an equal opportunity employer.… more
- Northwell Health (Garden City, NY)
- …combination of education and related experience. 2.Current License to practice as a Registered Professional Nurse in New York State required, plus specialized ... can be substantiated by the documentation in the Medical Record. Seeking RN candidates with a HCS-D - Home Care Coding Specialist-Diagnosis, COS-C Certificate… more
- Elevance Health (Indianapolis, IN)
- …and efficiency recommendations. **Minimum Requirements:** + Requires current, active, unrestricted Registered Nurse license in applicable state(s). + Requires a ... **Title:** Diagnosis Related Group Clinical Validation Auditor - RN (CDI, MS-DRG, AP-DRG and APR-DRG)...One or more of the following certifications are preferred: Registered Health Information Technician (RHIT), Registered Health… more
- Trinity Health (Fresno, CA)
- …or combination of equivalent experience and education is required. 2. Current licensure as a Registered Nurse ( RN ) with the state of California is required. ... Reporting to the Nurse Manager*, Cath Lab, the Nurse Auditor performs thorough chart review of Electronic Medical Records (EMR) documentation… more
- US Tech Solutions (Newark, NJ)
- …of related experience, preferably in the healthcare industry. + **Active New Jersey Registered Nurse ( RN ) License required.** **Skills:** + Knowledge of ... contract with potential extends or Convert** **Job Description:** + The HEDIS Nurse Auditor is responsible for conducting quality audits related to state audits,… more
- Providence (Torrance, CA)
- **Description** The Revenue Cycle Auditor is responsible for providing patient focused, standardized, compliant revenue cycle support that will assist Providence St ... Joseph Health in meeting financial objectives. - Conduct audits (individual chart/bill audits, focus audits, compliance audits, payer defense audits, patient requests for audit and post go live audit support). Providence caregivers are not simply valued -… more
- Robert Half Accountemps (Boston, MA)
- …to travel locally as needed + Strong analytical, organizational, and communication skills + RN ( Registered Nurse ) + Experience working in a Program Integrity ... Description Job Title: Medical Claims Auditor - RN Auditor Location: Massachusetts - 90% Remote Job Type: 1 Year Contract - Potential for Perm Hire Hours: 40… more
- Humana (Springfield, IL)
- …each day between 6AM and 9AM in their home time zone. **Required Qualifications** + Active Registered Nurse ( RN ) license in the state they reside. + Minimum ... of our caring community and help us put health first** The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record… more
- MD Anderson Cancer Center (Houston, TX)
- …reviews and audits of patient accounts to complete Defense Audits. *Ideal Candidate:* A * Registered Nurse ( RN )* with experience in *appeals* and * nurse ... As a * Nurse Defense Auditor * in our *Hospital...remote. Prefer Houston/local area. *LICENSES AND CERTIFICATIONS* * Required: RN - Registered Nurse -… more
- Stanford Health Care (Palo Alto, CA)
- …billing practices. + Proficient EXCEL, WORD, PowerPoint skills **Licenses and Certifications** + RN - Registered Nurse - State Licensure And/Or Compact ... Stanford Health Care job.** **A Brief Overview** The Charge Auditor performs auditing activities, including complex cases that require...and + CPC required . or + RHIT - Registered Health Information Technician required . or + RHIA… 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 ... as assigned. + LICENSES AND/OR CERTIFICATIONS + Current Virginia state license as a Registered Nurse or Registered Nurse holding a valid Compact State… more
- Insight Global (South Jordan, UT)
- …criteria, and coding terminology. * Expert coding knowledge (DRG & ICD-10) * Registered Nurse RN (must be inpatient) WITH coding/clinical documentation ... Job Description Insight Global is seeking a DRG Validation Auditor for one of our clients to sit 100%...(2 years in clinical documentation) OR IF NOT A NURSE : Degree in RHIM, RHIA, RHIT with medical coding… more
- CVS Health (Phoenix, AZ)
- …and scoring guidelines. + Participates in QM meetings. **Required Qualifications** + Active RN ( Registered Nurse ) or LPN (Licensed Practical Nurse ... heart, each and every day. **Position Summary** The **Healthcare Quality Management Auditor ** participates in the development and ongoing implementation of QM (… more
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