• Clinical Review Auditor

    Community Health Systems (Sarasota, FL)
    (Full-Time, Remote ) The Clinical Review Auditor is a professionally licensed nurse/LPN who is responsible for effectively managing the denial/appeal ... to patients in a dynamic changing environment. As an Clinical Review Auditor at Community...accounts by following HIPAA guidelines 13. **This is a remote position.** We know it's not just about finding… more
    Community Health Systems (01/15/25)
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  • Nurse Auditor / Senior Hospital Coder…

    TEKsystems (Chesapeake, VA)
    As the Nurse Auditor & Hospital Coder If you're ready to explore the next step in your career: You'll enjoy Career Opportunities - Tons of growth opportunities for ... between these hours of operation) Workplace Setting - 100% Remote with location restrictions (Must be 2 and a...direction from the Patient Financial Services Director, the Nurse Auditor / Revenue Integrity/ CDM Analyst is responsible for performing… more
    TEKsystems (01/07/25)
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  • Diagnosis Related Group Clinical Validation…

    Elevance Health (Metairie, LA)
    **Diagnosis Related Group Clinical Validation Auditor -** **Registered Nurse** **Location:** This position will work a hybrid model ( remote and office). Ideal ... one of our PulsePoint locations. The **Diagnosis Related Group Clinical Validation Auditor ** is responsible for auditing...the conditions and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims. **How… more
    Elevance Health (01/01/25)
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  • Senior Medical Auditor - Pediatrics (Work…

    UPMC (Pittsburgh, PA)
    …As the Senior Medical Auditor , you will provides technical expertise to review staff to ensure that all physicians, clinical , billing and coding staff ... **UPMC is hiring a full-time Senior Medical Auditor to join their Department of Pediatrics team!...either 8-hour or 10-hour shifts. This is a fully remote position that will supoort the staff at Children's… more
    UPMC (12/07/24)
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  • Lead, Auditor (RN) Appeals & Grievances…

    Molina Healthcare (Columbus, OH)
    …managed care or medical or behavioral health settings. + One year of auditing/ clinical review experience. + More than one-year supervisory experience. To all ... Registered Nurse with previous Appeals and Grievances experience and a clinical background. The candidate must have strong organization skills, proficient knowledge… more
    Molina Healthcare (01/13/25)
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  • Outpatient Coder/Nurse Auditor

    TEKsystems (Chesapeake, VA)
    …and review a high volume of accounts assigned to Revenue Integrity Nurse Auditor work queues for charge review of all observation account documentation to ... With direction from the Patient Financial Services Director, the Nurse Auditor / Revenue Integrity/CDM Analyst is responsible for performing audits of itemized… more
    TEKsystems (01/16/25)
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  • Inpatient Medical Coding Auditor

    Humana (Columbus, OH)
    …our caring community and help us put health first The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and ... In** Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for...**What Humana Offers** We are fortunate to offer a remote opportunity for this job. Our Fortune 100 Company… more
    Humana (12/12/24)
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  • Auditor

    Veterans Affairs, Veterans Health Administration (White River Junction, VT)
    Summary This Auditor position is within the Finance Service at the White River Junction VA Medical Center located in White River Junction, VT. This position is ... will provide oversight of finance, logistics, and capital asset management. The Auditor position assists the Financial Quality Assurance Manager in conducting audits… more
    Veterans Affairs, Veterans Health Administration (01/16/25)
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  • Diagnosis Related Group Auditor

    Hackensack Meridian Health (Hackensack, NJ)
    …serve as a leader of positive change. The **Diagnosis Related Group (DRG) Auditor ** is responsible for auditing clinical documentation that supports code ... includes compliance with the Conditions of Participation for CMS. The DRG auditor is responsible for ensuring coding accuracy, coding consistency and efficiency in… more
    Hackensack Meridian Health (12/06/24)
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  • Pharmacy Internal Auditor

    Elevance Health (Louisville, KY)
    **Pharmacy Internal Auditor ** **Location:** This position will work a hybrid model ( remote and office). Ideal candidates will live within 50 miles of one of our ... CarelonRx leverages the power of new technologies and a strong, clinical -first lens, to deliver member-centered, lasting pharmacy care. The **Pharmacy Internal… more
    Elevance Health (01/09/25)
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  • Quality Assurance Auditor II

    ICON Clinical Research (Blue Bell, PA)
    Quality Assurance Auditor II - USA (Home-Based with Travel) ICON plc is a world-leading healthcare intelligence and clinical research organization. We're proud ... us on our mission to shape the future of clinical development. We have an incredible opportunity for a...We have an incredible opportunity for a Quality Assurance Auditor II to join ICON's Full Service Quality &… more
    ICON Clinical Research (01/08/25)
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  • Senior GCP Auditor

    Chiesi (Cary, NC)
    …Mock Inspections inside Global R&D departments. + Execution of second party audits ( remote and on-site) to Clinical Research Organizations (CRO), Clinical ... Senior GCP Auditor Date: Jan 10, 2025 Department: Corporate R&D...assure the compliance and the correct application of Good Clinical Practice (GCP), inside the clinical development… more
    Chiesi (12/13/24)
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  • Ad-Hoc GLP Auditor

    Actalent (Hanover, MD)
    …Title: GLP QA AuditorJob Description We are seeking a highly skilled GLP QA Auditor to lead the planning, conducting, and reporting of GLP audits. The role involves ... study director, highlighting any issues encountered and corrective actions taken. + Review final study reports to ensure they accurately reflect the methods,… more
    Actalent (01/15/25)
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  • Coding Quality Auditor - $5,000 Sign-On…

    Houston Methodist (Miami, FL)
    **Coding Quality Auditor - 100% Remote (Must Live in FL, TN, GA, LA, WA State, or TX)** At Houston Methodist, the Coding Quality Auditor position is ... rules and regulatory body guidelines. This position performs data quality review to ensure data integrity, coding accuracy, and revenue preservation. Additional… more
    Houston Methodist (12/31/24)
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  • Coding Denial Auditor

    R1 RCM (Detroit, MI)
    …reducing operating costs and enhancing the patient experience. The Coding Denial Auditor will be responsible for reviewing denial coded cases for coding completeness ... + Audits records as defined in the coding quality review plan. Review cases flagged by the...multi-hospital health system is preferred + Training in hospital Clinical Documentation Improvement is preferred + Experience as a… more
    R1 RCM (01/07/25)
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  • Coding Quality Auditor - $5000 Sign-On…

    Houston Methodist (Houston, TX)
    **Coding Quality Auditor - 100% Remote (Must Live in FL, TN, GA, LA, WA State, or TX)** At Houston Methodist, the Coding Apprentice position is responsible for ... requests. Responds promptly and appropriately to requests to code or review coded accounts for accuracy. **QUALITY/SAFETY ESSENTIAL FUNCTIONS** + Maintains and… more
    Houston Methodist (01/01/25)
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  • Coding Educator/ Auditor

    Insight Global (Charlottesville, VA)
    Job Description Insight global is seeking a remote Professional Coding Educator for a healthcare system in Virginia. The educator will provide consulting services to ... and local regulatory compliance standards. Creates and delivers presentations to clinical faculty and billing staff. Develops training programs and delivers training… more
    Insight Global (12/06/24)
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  • Compliance Auditor - Enterprise Risk…

    Bon Secours Mercy Health (Cincinnati, OH)
    …effectiveness. Our hospitals, care sites and clinicians are recognized for clinical and operational excellence. **Summary** Works collaboratively with the Compliance ... for Bon Secours Mercy Health. **Essential Job Functions** + Assists in the review of Bon Secours Mercy Health coding, billing and claims processing policies and… more
    Bon Secours Mercy Health (11/25/24)
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  • Clinical Documentation Improvement (CDI)…

    UT Health (Houston, TX)
    … Documentation Improvement (CDI) - Cardio/Cardio Surgical - ( Remote ) **Location:** Houston, Texas **Hot** **Category:** Professional/Managerial McGovern Medical ... + **Department: Revenue Cycle** + **Status: Full-time** + **Location: Remote ** + **2 years of Cardio/Cardio Surgical coding &...at least 2 years of experience as a pro-fee coder/ auditor and/or healthcare billing compliance or clinical more
    UT Health (12/23/24)
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  • Clinical Studies Coordinator - Regulatory

    MD Anderson Cancer Center (Houston, TX)
    The Coordinator, Clinical Studies - Regulatory - ensures regulatory compliance for the Department of Genitourinary Medical Oncology clinical trials, assists with ... the institutional and federal approval procedures for research laboratory and clinical trials and provides education relevant to regulatory matters to the research… more
    MD Anderson Cancer Center (01/15/25)
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