- Elevance Health (Seattle, WA)
- **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
- Centene Corporation (New York, NY)
- …Diagnosis Related Group (DRG) and Medical Record Audit Programs for Fidelis Care. The Clinical Coding Auditor & Trainer position is primarily remote with a small ... Skills:** + Inpatient Coding Experience + At least 1 year of clinical experience in a hospital setting + RN , PA, MD, APRN, DO or MBBS license required + Strong… more
- UNC Health Care (Chapel Hill, NC)
- …Association) certification - AAPC (American Academy of Professional Coders) certification - RN ( Registered Nurse ) license - LPN (Licensed Practical ... across the state to train and shadow round with Clinical Documentation Specialists. The CDS auditor provides elbow to elbow support during training and education… more
- AdventHealth (Orlando, FL)
- …role you'll contribute:** The Clinical Documentation Integrity Manager is a Registered Nurse and/or a Registered Health Information Administrator with ... clinical proficiency necessary for the oversight of the Clinical Documentation team which is comprised of registered...Licenses and Certifications Current active State license as a Registered Nurse , Nurse Practitioner, Physicians… more
- CommonSpirit Health Mountain Region (Centennial, CO)
- …with resources to help you flourish and leaders who care about your success. The clinical auditor performs clinical and operational audits as a means of ... years direct patient care in a hospital setting + RN experience highly preferred; although technical skills and medical...and medical experience may substitute. + State of employment RN license, preferred Physical Requirements - Medium Work -… more
- AdventHealth (Tampa, FL)
- …be adaptable and flexible as required. Regional Travel up to 20% may be required. Registered Nurse ( RN ) Florida Required This facility is an equal ... Research Institute, also located at AdventHealth Tampa, leads the way in clinical and academic research in the areas of neuroscience, cardiovascular medicine,… more
- 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 (Westbury, NY)
- …combination of education and related experience. 2.Current License to practice as a Registered Professional Nurse in New York State required, plus specialized ... the assignment can be substantiated by the documentation in the Medical Record. Seeking RN - BSN or MSN candidates with a HCS-D - Home Care Coding… 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 ... months contract with potential extends or Convert** **Job Description:** + The HEDIS Nurse Auditor is responsible for conducting quality audits related to state… 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
- 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
- BayCare Health System (Raleigh, NC)
- …and Licensures + **Required:** RHIA/RHIT in conjunction with CCS + **Preferred:** RN , CDIP, CCDS, or clinical degree Education + **Required:** associate's ... 7:00 AM to 3:30 PM + **Days:** Monday - Friday The Inpatient Coding Auditor is a full-time remote position. _Sign on bonuses available!_ Responsibilities + 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
- US Tech Solutions (Hopewell, NJ)
- …+ Requires License Practical Nurse License or an active New Jersey Registered Nurse License. + Requires valid Motor Vehicle driver's license and access ... preparing weekly, monthly, quarterly and year-end reports. **Note: Candidates need RN OR LPN New Jersey License** **Responsibilities:** + Conducts on-site reviews… more
- Guthrie (Sayre, PA)
- Summary: A senior level compliance coding auditor conducting assessments in accordance with The Guthrie Clinic's policies and procedures and accepted guidelines for ... and billing and/or compliance field required 5 year of clinical experience and/or knowledge and understanding of Medical Records...(RHIA, RHIT, or CCS) or AAPC (CPC) required + RN /LPN or CPMA preferred + Required to sit for… more
- Trinity Health (Ann Arbor, MI)
- …travelling between locations within the region. **MINIMUM QUALIFICATIONS** **Licensure/Certification:** Registered Nurse or Licensed Vocational Nurse / ... Patient Business Service (PBS) center and ensures compliant and complete clinical documentation, assists with denials and related audits, and identifies… more
- Ochsner Health (New Orleans, LA)
- …field. **Certifications** Required - Certification as CPC, CCS, CHC, RHIA, RHIT, RN , or LPN or other related certification. **Knowledge Skills and Abilities (KSAs)** ... + Ability to travel across system. **Job Duties** + Independently completes clinical compliance audits. + Reports audit findings and ensures development of… more
- SSM Health (MO)
- …Division of Professional Registration + Or + Physician - Regional MSO Credentialing + Or + Registered Nurse ( RN ) Issued by Compact State + Or + Registered ... vital member of the interdisciplinary care team member, an auditor , and an educator ensuring medical records are complete...+ Physician - Regional MSO Credentialing + Or + Registered Nurse ( RN ) Issued by… more
- Excellus BlueCross BlueShield (Dewitt, NY)
- … clinical expertise (ex. Social Work, Behavioral Health, Respiratory Therapy, Registered Dietitian, Registered Nurse , Medical Director, Pharmacist, ... All Levels + Associates degree required. Bachelor's degree preferred. + Active NYS RN or Registered Dietician or Physical Therapist licensure required; or LMSW;… more