• Clinical Auditor /Analyst…

    UPMC (Pittsburgh, PA)
    …Maintain or exceed designated quality and production goals. Maintain employee/insured confidentiality. Registered Nurse ( RN ). Bachelor of Science in Nursing ... UPMC Health Plan has an exciting opportunity for a Clinical Auditor /Analyst Intermediate! The Clinical ...CIC, CCA, CCS, CCS-P) or AHFI designation required. + Registered Nurse ( RN ) + Act… more
    UPMC (01/06/26)
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  • Clinical Auditor RN - Hybrid

    Baylor Scott & White Health (Dallas, TX)
    …vary based on 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 documentation from the Electronic Health Record (EHR) compared...least (2) two years of relevant work experience. + Registered Nurse License. As a health care… more
    Baylor Scott & White Health (12/25/25)
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  • Clinical Revenue Auditor -CDM…

    Mount Sinai Health System (New York, NY)
    **Job Description** ** Clinical Revenue Auditor -CDM Patient Financial Services -Corporate-Full-Time-Days- Hybrid.** The Clinical Revenue Auditor for ... Practice Plan) is responsible for reviewing and verifying that all billable services and procedures provided to patients are accurately documented, coded, and… more
    Mount Sinai Health System (12/24/25)
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  • Quality Improvement Auditor

    Centene Corporation (Atlanta, GA)
    …findings, including clinical recommendations to assure the delivery of quality services + Lead case reviews to assess the clinical performance provided ... years of nursing or quality improvement experience. **Licenses/Certifications:** Current state's clinical license (LPN, RN , etc.).Pay Range: $56,200.00 -… more
    Centene Corporation (01/06/26)
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  • DRG Revenue Integrity Auditor

    Insight Global (Plano, TX)
    …in an acute care setting or a third-party vendor as a DRG Auditor or Clinical Documentation Specialist (CDS). -CCS Certification RN or BSN RHIT or RHIA ... DRG Auditors to join a remote healthcare organization. The DRG Revenue Integrity Auditor will perform Diagnostic Related Group (DRG) validation and quality audits on… more
    Insight Global (10/30/25)
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  • Nurse Auditor 2

    Humana (Madison, WI)
    **Become a part of our caring community and help us put health first** The Nurse Auditor 2 performs clinical audit/validation processes to ensure that ... complete, compliant and accurate to support optimal reimbursement. The Nurse Auditor 2 work assignments are varied...in their home time zone. **Required Qualifications** + Active Registered Nurse ( RN ) license in… more
    Humana (01/06/26)
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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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  • Clinical Documentation Specialist…

    UNC Health Care (Chapel Hill, NC)
    …Association) certification - AAPC (American Academy of Professional Coders) certification - RN ( Registered Nurse ) license - LPN (Licensed Practical ... are owned or managed that have opted into shared services . This position reports to the HCS Supervisor Coding...across the state to train and shadow round with Clinical Documentation Specialists. The CDS auditor provides… more
    UNC Health Care (12/31/25)
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  • ( RN ) Registered Nurse

    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
    Northwell Health (12/20/25)
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  • Cardiovascular Services RN

    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. ... to the Nurse Manager*, Cath Lab, the Nurse Auditor performs thorough chart review of...3. Four (4) years clinical experience in cardiovascular service environment is… more
    Trinity Health (12/08/25)
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  • RN -Charge Auditor

    Essentia Health (Duluth, MN)
    **Job Description:** The Registered Nurse - Charge Auditor plans, conducts, and performs charge audits, based on clinical documentation and billing ... Requirements: + Current licensure by the applicable state board of nursing as an RN ( Registered Nurse ) Employee Benefits at Essentia Health: At Essentia… more
    Essentia Health (01/08/26)
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  • HEDIS RN - Quality Auditor

    US Tech Solutions (Newark, NJ)
    …of related experience, preferably in the healthcare industry. + **Active New Jersey Registered Nurse ( RN ) License required.** **Skills:** + Knowledge of ... months contract with potential extends or Convert** **Job Description:** + The HEDIS Nurse Auditor is responsible for conducting quality audits related to state… more
    US Tech Solutions (11/20/25)
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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 ... compliance with billing regulations and trends in denials of services due to medical necessity or appropriateness of ...AND/OR CERTIFICATIONS + Current Virginia state license as a Registered Nurse or Registered more
    Childrens Hospital of The King's Daughters (10/23/25)
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  • DRG Auditor - February Class

    Insight Global (South Jordan, UT)
    …terminology. Expert coding knowledge (DRG & ICD-10) Registered Nurse RN (must be inpatient) WITH coding/ clinical documentation certification (2 years in ... Job Description Insight Global is seeking a DRG Validation Auditor for one of our clients to sit 100%...clinical documentation) OR IF NOT A NURSE : Degree in RHIM, RHIA, RHIT with medical coding… more
    Insight Global (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 ... therefrom. Licensure, Registration and/or Certification: Valid multi-state or State of Oklahoma Registered Nurse License. Work Experience: Minimum 3 years of… more
    Saint Francis Health System (12/23/25)
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  • DRG Denials Auditor

    Community Health Systems (Franklin, TN)
    **Job Summary** The DRG Denials Auditor conducts hospital inpatient DRG denial audits for both RAC and non-RAC accounts, reviewing patient records for accuracy in ... ICD-10-CM/PCS coding, DRG assignments, and supporting clinical documentation. This includes evaluating present on admission (POA)...any other relevant data to ensure coding accuracy. The auditor is also responsible for writing and defending appeal… more
    Community Health Systems (12/09/25)
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  • Rev Integrity Auditor Sr

    Covenant Health Inc. (Knoxville, TN)
    …study or current clinical license/registration in the State of Tennessee as RN with equivalent coding experience. Apply/Share Job Title REV INTEGRITY AUDITOR ... Overview Revenue Integrity Auditor Full Time, 80 Hours Per Pay Period, Day Shift Covenant Health Overview: Covenant Health is the region's top-performing healthcare… more
    Covenant Health Inc. (11/14/25)
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  • Senior Healthcare Auditor

    University of Washington (Seattle, WA)
    **Job Description** The senior healthcare auditor is responsible for the completion of internal audits within the clinical integrated parts of the University of ... work performed and conclusions drawn so other reviewers can follow the auditor 's logic and methodology. . Effectively evaluates audit results, weighing the… more
    University of Washington (10/31/25)
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  • Health Plans Licensed Practical Nurse LPN…

    Banner Health (AZ)
    **Department Name:** Banner Staffing Services -AZ **Work Shift:** Day **Job Category:** Risk, Quality and Safety **Estimated Pay Range:** $26.40 - $44.00 / hour, ... experience. In accordance with State Pay Transparency Rules. Banner Staffing Services (BSS) also offers Registry/Per Diem opportunities within Banner Health.… more
    Banner Health (11/27/25)
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  • Clinical Documentation Specialist, Second…

    SSM Health (MO)
    …Division of Professional Registration + Or + Physician - Regional MSO Credentialing + Or + Registered Nurse ( RN ) Issued by Compact State + Or + Registered ... + Maintains knowledge of Centers for Medicare and Medicaid Services (CMS) requirements related to clinical documentation...+ Physician - Regional MSO Credentialing + Or + Registered Nurse ( RN ) Issued by… more
    SSM Health (11/21/25)
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