- 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...CERTIFICATIONS + Current Virginia state license as a Registered Nurse or Registered Nurse holding a valid… more
- Elevance Health (Hanover, MD)
- **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 ** is responsible for auditing inpatient medical records… more
- UNC Health Care (Chapel Hill, NC)
- …from entity to entity across the state to train and shadow round with Clinical Documentation Specialists. The CDS auditor provides elbow to elbow support during ... we serve. Summary: This positon trains and audits Inpatient and Outpatient Clinical Documentation Specialists (CDS) across all HCS entities that are owned or… more
- Trinity Health (Ann Arbor, MI)
- …Patient Business Service (PBS) center and ensures compliant and complete clinical documentation, assists with denials and related audits, and identifies ... root causes, which includes performing thorough chart reviews, providing education to clinical colleagues, and tracking of identified trends. Leverages clinical … more
- Northwell Health (Westbury, NY)
- …a HCS-D - Home Care Coding Specialist-Diagnosis, COS-C Certificate for OASIS Specialist- Clinical . Conducts Home Health Resource Group (HHRG) Validation to ensure the ... + Instructs professional staff in code changes, as needed. + Assists clinical staff and nursing supervisors in providing appropriate documentation in the Medical… more
- AdventHealth (Tampa, FL)
- …Research Institute, also located at AdventHealth Tampa, leads the way in clinical and academic research in the areas of neuroscience, cardiovascular medicine, ... This position conducts chart audits comparing charges with physician orders, clinical documentation, and reports while reviewing and correcting any charge errors… more
- Ascension Health (Wichita, KS)
- …accuracy of billing through verification of coding, billing and supporting clinical documentation. + Coordinate all activities associated with insurance carrier ... potential. **Requirements** Licensure / Certification / Registration: + Licensed Registered Nurse credentialed from the Kansas Board of Nursing required. Education:… more
- Northwell Health (Garden City, NY)
- …HCS-D - Home Care Coding Specialist-Diagnosis, COS-C Certificate for OASIS Specialist- Clinical . Validates Acute Inpatient coded charts to ensure the diagnostic ... by the documentation in the Medical Record. Job Responsibility 1.Leverages clinical expertise to identify and validate DRG code assignment. 2.Full review… more
- AdventHealth (Orlando, FL)
- …Full Time **Shift** : Days **Location: Remote** **The role you'll contribute:** The Clinical Documentation Integrity Manager is a Registered Nurse and/or a ... Registered Health Information Administrator with a high level of clinical proficiency necessary for the oversight of the Clinical Documentation team which is… more
- Virtua Health (Mount Laurel, NJ)
- …over 2,850 skilled and compassionate doctors, physician assistants, and nurse practitioners equipped with the latest technologies, treatments, and techniques ... Coding Audit Response: Conducts Trains new coders to utilize the medical record, clinical , coding and abstracting systems, in conjunction with UHDDS and other rules… more
- Insight Global (South Jordan, UT)
- …and coding terminology. * Expert coding knowledge (DRG & ICD-10) * Registered Nurse RN (must be inpatient) WITH coding/ clinical documentation certification (2 ... Job Description Insight Global is seeking a DRG Validation Auditor for one of our clients to sit 100%...in clinical documentation) OR IF NOT A NURSE : Degree in RHIM, RHIA, RHIT with medical coding… more
- US Tech Solutions (Newark, NJ)
- …months contract with potential extends or Convert** **Job Description:** + The HEDIS Nurse Auditor is responsible for conducting quality audits related to state ... to identify trends and facilitate quality improvement initiatives. + Assist with clinical studies, quality projects, and audits. + Lead and coordinate Corrective… more
- SSM Health (MO)
- …Summary:** Performs as a vital member of the interdisciplinary care team member, an auditor , and an educator ensuring medical records are complete and clinical ... and electronic health record charts that accurately capture the clinical picture. **Job Responsibilities and Requirements:** PRIMARY RESPONSIBILITIES + Reviews… more
- Baystate Health (Springfield, MA)
- …MD schedules for clinical team inquiry. In coordination with the charge nurse , prepare staffing assignments for the next shift. Place calls to replace unplanned ... be applicable to this role.** **Summary:** **Reports to the Nurse Manager but daily activities are coordinated by the...also as a business partner to the department and clinical staff. Orients patients and families to the unit,… more
- Baystate Health (Springfield, MA)
- …records, Kronos variance forms, etc. **8)** Unit Resource: Post/file MD schedules for clinical team inquiry. In coordination with charge nurse , prepare staffing ... be applicable to this role.** **Summary:** Reports to the Nurse Manager but daily activities are coordinated by the...also as a business partner to the department and clinical staff. Orients patients and families to the unit,… more
- Trinity Health (Livonia, MI)
- …Maintains productivity standards Maintains compliance with regulatory requirements Assist Nurse Auditor and/or Coordinator with denial coordination process; ... including but not limited to, appending modifiers, and checking clinical documentation. Provides feedback to intra-departmental Revenue Integrity colleagues… more
- Medical Mutual of Ohio (OH)
- …Supports interdepartmental and vendor project planning coordination and facilitation. Works with IT and Clinical Nurse staff to aid in the loading of HEDIS data ... Supports interdepartmental and vendor project planning coordination and facilitation. Works with IT and Clinical Nurse staff to aid in the loading of HEDIS data… more
- NCH (Naples, FL)
- + DEPARTMENT: 17117 - Clinical Documentation Integrity + LOCATION: 350 7th Street North, Naples, FL, 34102 + WORK TYPE: Full Time + WORK SCHEDULE: Standard Office ... and fellowships; Have endowed chairs; Conduct research and participate in national clinical trials; and partner with other health market leaders, like Hospital for… more
- AdventHealth (Altamonte Springs, FL)
- …FL **The role you will contribute:** Under general supervision of the Clinical Documentation Integrity (CDI) Manager, and in some situations the supervision of ... the Director of Clinical Documentation Integrity, and in collaboration with physicians, nursing...practitioners, nursing, care management and quality abstracters. The Quality Auditor Manager adheres to strict departmental and organizational goals,… more
- Excellus BlueCross BlueShield (Dewitt, NY)
- …drivers. Essential Accountabilities: Level I + Handles physical health member clinical management programs. + Maintains knowledge of current Case Management Society ... or external referral sources. Applies case management criteria and professional clinical judgment to determine a member's appropriateness for case management… more