• RN Auditor , Clinical

    Molina Healthcare (Columbus, OH)
    For this position we are seeking a ( RN ) Registered Nurse who...and must be licensed for the state they reside Clinical Auditor RN will support ... 5 PM EST **KNOWLEDGE/SKILLS/ABILITIES** + Performs monthly auditing of registered nurse and other clinical ...them. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ) Program and… more
    Molina Healthcare (01/24/25)
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  • Clinical Auditor RN

    Providence (Fullerton, CA)
    **Description** Clinical Auditor ( RN ) in our Surgical Services Department at Providence St. Jude Medical Center in Fullerton, CA. This is a full-time ... must empower them. **Required Qualifications:** + Upon hire: California Registered Nurse License. + 1 year Operating...clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas… more
    Providence (01/27/25)
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  • RN ( Registered Nurse

    Molina Healthcare (Reno, NV)
    …required. Pacific Time Zone hours** **KNOWLEDGE/SKILLS/ABILITIES** + Performs monthly auditing of registered nurse and other clinical functions in ... Management (HM), and/or Disease Management (DM). + Monitors key clinical staff for compliance with NCQA, CMS, State and...them. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ) Program and… more
    Molina Healthcare (12/06/24)
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  • Nurse Auditor , Days, (OR exp…

    Houston Methodist (Houston, TX)
    …to accurately support reasons for treatment, billing, payment or operations. The Nurse Auditor position ensures clinical documentation supports all ... At Houston Methodist, the Nurse Auditor position is responsible auditing...or hospital setting **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -… more
    Houston Methodist (12/26/24)
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  • RN Clinical Documentation…

    Ascension Health (Wichita, KS)
    …Specialists obtained prior to hire date or job transfer date required. + Licensed Registered Nurse credentialed from the Kansas Board of Nursing obtained prior ... the offer._ **Responsibilities** Develop, implement, and has oversight over the Clinical Documentation Integrity (CDI) audit plan, utilizing audit findings to… more
    Ascension Health (12/24/24)
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  • Clinical Trials Applications Specialist II

    AdventHealth (Orlando, FL)
    …University Research Administrators (NCURA), Research Administrator's Certification Council (RACC) + Registered Nurse _2/28/22_ This facility is an equal ... one of the busiest hospitals in the nation, providing service excellence to more than 32,000 inpatients and 125,000... research in a related role, such as a clinical research coordinator, monitor, auditor , clinical more
    AdventHealth (11/26/24)
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  • ( RN ) HCS-D, COS-C - Registered

    Northwell Health (Westbury, NY)
    …five (5) years of job entry date. + Current License to practice as a Registered Professional Nurse in New York State required, plus specialized certifications as ... **Req Number** 128397 Job Description Seeking RN - BSN or MSN candidates with a...- Home Care Coding Specialist-Diagnosis, COS-C Certificate for OASIS Specialist- Clinical . Conducts Home Health Resource Group (HHRG) Validation to… more
    Northwell Health (12/02/24)
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  • Clinical Research Monitoring Specialist…

    University of Pennsylvania (Philadelphia, PA)
    …or related field preferred. Minimum of seven years of experience as a clinical research monitor/ auditor , research nurse or research coordinator with ... of Operations, Compliance and Monitoring (DOCM) is seeking a clinical research monitor/ auditor to support our ...you cover some of the costs of long-term care services received at home, in the community or in… more
    University of Pennsylvania (01/23/25)
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  • RN Compliance Auditor

    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 ... to prevent and detect fraud, waste, and abuse. The RN Compliance Nurse 2, Quality Assurance Audit... experience in an acute care, skilled and/or rehabilitation clinical setting + Experience with utilization management, pre- service more
    Humana (01/31/25)
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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 (01/25/25)
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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 ... 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 (01/25/25)
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  • Revenue Integrity Nurse Auditor

    Trinity Health (Columbus, OH)
    **Employment Type:** Full time **Shift:** **Description:** ** Nurse Auditor , Revenue Integrity** **Position Purpose:** Responsible for coordinating denials with ... May be require to travel between locations within the Region. **Minimum Requirements:** + Registered Nurse and graduate of an accredited school of nursing plus… more
    Trinity Health (01/25/25)
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  • Cardiovascular Nurse Auditor , Cath…

    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 (01/18/25)
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  • Sr Coding Compliance Auditor

    Catholic Health Initiatives (Chattanooga, TN)
    …Management Service Organization (MSO) that provides comprehensive office management services for all Memorial Health Partners and many physicians in private ... to include review, education and necessary follow-up to help ensure that clinical documentation and coding services meet government and organizational policies… more
    Catholic Health Initiatives (12/23/24)
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  • Coding Auditor - Inpatient

    BayCare Health System (Atlanta, GA)
    …and Licensures** + Required - RHIA/RHIT in conjunction with CCS + Preferred - RN , CDIP, CCDS, or clinical degree **Education** + Required - associate's degree ... Team Member who is passionate about providing outstanding customer service to our community. We are looking for an...PM + **Days:** Monday - Friday The **Inpatient** **Coding Auditor ** is a full-time remote position. This team member… more
    BayCare Health System (01/22/25)
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  • Charge Integrity Auditor

    Nuvance Health (Danbury, CT)
    …. a. Reviews individual charge procedures related to each case, identified correct service codes on supplies and/or services . b. Performs review for carve ... *Description* *Summary:* The Charge Integrity Auditor performs detailed chart to bill audits of...record. The audit process begins with registration, orders and clinical workflows. Ensures that the charge triggers work and… more
    Nuvance Health (01/09/25)
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  • Nurse Auditor /Rev Intgty Spec

    Chesapeake Regional Healthcare (Chesapeake, VA)
    Job Summary With direction from the Director, the Nurse Auditor /Revenue Integrity Specialist is responsible for auditing itemized charges versus the patient ... and advising the billing staff of appropriate HCPCS codes and modifiers. The Nurse Auditor / Revenue Integrity Specialist works directly with revenue producing… more
    Chesapeake Regional Healthcare (01/04/25)
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  • Hospice Compliance Auditor

    BrightSpring Health Services (Louisville, KY)
    …to the governing board + Additional responsibilities as assigned Qualifications + Registered Nurse with current licensure to practice in assigned state(s) ... Our Company BrightSpring Health Services Overview Our Hospice Compliance Auditors are responsible...League for Nursing preferred + Three years' experience in clinical nursing, hospice experience preferred + Two years of… more
    BrightSpring Health Services (01/30/25)
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  • Clinic Quality Manager Auditor 3

    Fresenius Medical Center (Irwindale, CA)
    …+ Collaborates with appropriate stakeholders including but not limited to the Clinical Quality leadership, Education, Clinical Services , Regulatory and ... related field preferred or an equivalent combination of education and experience + Registered Nurse required + Certification in Nephrology Nursing or quality… more
    Fresenius Medical Center (12/31/24)
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  • Sr. Compliance Auditor

    Ochsner Health (New Orleans, LA)
    …and ensures assignment objectives are achieved. Ensures that projects, coverage and services are completed as defined for areas of responsibility in the department's ... field. **Certifications** Required - Certification as CPC, CCS, CHC, RHIA, RHIT, RN , or LPN or other related certification. **Knowledge Skills and Abilities (KSAs)**… more
    Ochsner Health (02/02/25)
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