- UNC Health Care (Chapel Hill, NC)
- …Association) certification - AAPC (American Academy of Professional Coders) certification - RN ( Registered Nurse ) license - LPN (Licensed Practical ... position reports to the HCS Supervisor Coding and CDI Quality and Training. This position may travel from entity...across the state to train and shadow round with Clinical Documentation Specialists. The CDS auditor provides… more
- Centene Corporation (Atlanta, GA)
- …nursing or quality improvement experience. **Licenses/Certifications:** Current state's clinical license (LPN, RN , etc.).Pay Range: $56,200.00 - $101,000.00 ... business processes to measure member outcomes. Assess provider performance and quality of care through clinical case reviews. + Lead clinical audits for… more
- Intermountain Health (Murray, UT)
- …support exceptional patient care. We're looking for a compassionate, sharp, and collaborative RN Auditor ready to make an impact in a fast‑paced, mission‑driven ... Cost Report. **Scope:** + This position works with the Quality Department, and other Intermountain entities and staff to...RN License in state of practice. + Demonstrated clinical nursing experience in a diverse setting. + Demonstrated… more
- Bloom Healthcare (Lakewood, CO)
- …we are committed to delivering high- quality , compliant, and patient-centered end-of-life care. The RN Clinical Auditor plays a vital role in supporting ... This full-time position is designed for an experienced hospice Registered Nurse with strong clinical ...interest in quality improvement and education. The RN Clinical Auditor conducts comprehensive… more
- Elevance Health (Chicago, IL)
- **Diagnosis Related Group Clinical Validation Auditor - RN (CDI, MS-DRG, AP-DRG and APR-DRG)** **Virtual:** This role enables associates to work virtually ... an accommodation is granted as required by law. The **Diagnosis Related Group Clinical Validation Auditor - RN ** is responsible for auditing inpatient medical… more
- UPMC (Pittsburgh, PA)
- …or exceed designated quality and production goals. Maintain employee/insured confidentiality. Registered Nurse ( RN ). Bachelor of Science in Nursing (BSN) ... 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
- US Tech Solutions (Newark, NJ)
- …with potential extends or Convert** **Job Description:** + The HEDIS Nurse Auditor is responsible for conducting quality audits related to state audits, ... + Support data services to identify trends and facilitate quality improvement initiatives. + Assist with clinical ...preferably in the healthcare industry. + **Active New Jersey Registered Nurse ( RN ) License required.**… more
- 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 the ... financial health and compliance of the organization and bridges the gap between clinical care and medical billing and reimbursement. This position will report to the… more
- Cleveland Clinic (Cleveland, OH)
- …Preferred qualifications for the ideal future caregiver include: + Advanced degree + RN with a Clinical background + Healthcare auditing experience + ... healthcare organizations in the world. As a Senior Internal Auditor , you will conduct audit procedures for assigned audits,...Clinic, its subsidiaries, and affiliates. This role leverages both clinical expertise and auditing skills to ensure that … more
- 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
- 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 ... focus audits and reports findings. + Serves as a clinical resource for coding / denial management and customer...AND/OR CERTIFICATIONS + Current Virginia state license as a Registered Nurse or Registered … more
- 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
- 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
- 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 … more
- Covenant Health Inc. (Knoxville, TN)
- …or current clinical license/registration in the State of Tennessee as RN with equivalent coding experience. Apply/Share Send this job to a friend ... Overview Revenue Integrity Auditor Full Time, 80 Hours Per Pay Period,...and 1,500 affiliated physicians are dedicated to improving the quality of life for the more than two million… more
- 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
- Centene Corporation (Jefferson City, MO)
- … Social Worker (LCSW), Licensed Mental Health Counselor (LMHC), Licensed Professional Counselor (LPC), Registered Nurse ( RN ), or Licensed Practical Nurse ... the auditing of corporate, health plan, and specialty company staff related to clinical systems entry and/or processes + Develop and maintain the audit process and… more
- Banner Health (AZ)
- …and High Volume Specialists (HVS). This position is also responsible for assisting the QM RN with the investigation and research of quality of care concerns that ... **Department Name:** Banner Staffing Services-AZ **Work Shift:** Day **Job Category:** Risk, Quality and Safety **Estimated Pay Range:** $26.40 - $44.00 / hour,… more
- St. Luke's University Health Network (Allentown, PA)
- …serve, regardless of a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, ... Works inside with adequate lighting, comfortable temperature and ventilation. EDUCATION: Registered Nurse required, BSN preferred. Current license required. .… more
- University of Washington (Seattle, WA)
- …changes impacting revenue cycle **REQUIREMENTS** + Active licensure to practice as a Registered Nurse in Washington State + Bachelor's degree in Nursing + ... Medicine's Patient Financial Services Department** has an outstanding opportunity for a ** Clinical Appeals and Disputes Nurse .** **WORK SCHEDULE** + 100% FTE… more
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