- Actalent (West Des Moines, IA)
- Job Title: Nurse Auditor Job Description We are seeking a highly skilled Nurse Auditor who can understand the intricacies of standard medical coding, ... claim types and identifying claims requiring further review. The Nurse Auditor will also maintain productivity goals,...(RN) license required. + 3+ years of experience in medical record review, billing, and auditing. + Vast knowledge… more
- Actalent (West Des Moines, IA)
- …understanding of standard medical coding, including CPT, ICD-10, and HCPCS. The Nurse Auditor is responsible for adjudicating claims to comply with client ... Job Title: Nurse Auditor Job Description This role...(RN) license required. + 3+ years of experience in medical record review, billing, and auditing with extensive knowledge… 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 ... reimbursement to the health system from third party payers. Reports to the...regulations and trends in denials of services due to medical necessity or appropriateness of services. + Conducts compliance,… more
- Trinity Health (Ann Arbor, MI)
- …between locations within the region. **MINIMUM QUALIFICATIONS** **Licensure/Certification:** Registered Nurse or Licensed Vocational Nurse / Licensed Practical ... CHRI certification/membership strongly preferred. Knowledge of and experience in health care including government payers, applicable federal and state regulations,… more
- Ascension Health (Wichita, KS)
- …Francis St, Wichita, Kansas 67214 **Benefits** Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match ... Coordinate payer denials and appeals, respond to insurance company requests for medical records, and perform medical record reviews. + Review … more
- Northwell Health (Westbury, NY)
- …Coding Specialist-Diagnosis, COS-C Certificate for OASIS Specialist-Clinical. Conducts Home Health Resource Group (HHRG) Validation to ensure the diagnostic ... to the assignment can be substantiated by the documentation in the Medical Record. Job Responsibility + Audits and reviews Medicare/non-Medicare charts to ensure… more
- Northwell Health (Garden City, NY)
- …to the assignment can be substantiated by the documentation in the Medical Record. Job Responsibility 1.Leverages clinical expertise to identify and validate DRG ... and related experience. 2.Current License to practice as a Registered Professional Nurse in New York State required, plus specialized certifications as needed.… more
- UPMC (Pittsburgh, PA)
- …Coder (CIC) + Certified Evaluation & Management Coder (CEMC) + Certified Professional Medical Auditor (CPMA) + Certified Professional Coder (CPC) + Certified ... Medical Coder (CMC) + OR Registered Health ...Health Information Technician (RHIT) + OR Licensed Professional Nurse (LPN) + Registered Nurse (RN) Required:… more
- Elevance Health (Hanover, MD)
- …is granted as required by law. The **Diagnosis Related Group Clinical Validation Auditor ** is responsible for auditing inpatient medical records to ensure ... **Diagnosis Related Group Clinical Validation Auditor -RN (CDI, MS-DRG, AP-DRG and APR-DRG)** **Virtual:** This...an impact:** + Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines, and objectivity in… more
- UPMC (Pittsburgh, PA)
- …Coder (CIC) + Certified Evaluation & Management Coder (CEMC) + Certified Professional Medical Auditor (CPMA) + Certified Professional Coder (CPC) + Certified ... Medical Coder (CMC) + Registered Health Information Administrator (RHIA) + Registered Health Information Technician (RHIT) + Licensed Professional Nurse … more
- UNC Health Care (Chapel Hill, NC)
- …inclusive organization with over 40,000 teammates, whose mission is to improve the health and well-being of the unique communities we serve. Summary: This positon ... the state to train and shadow round with Clinical Documentation Specialists. The CDS auditor provides elbow to elbow support during training and education as well as… more
- Virtua Health (Mount Laurel, NJ)
- …benefits for full-time and part-time colleagues, including, but not limited to: medical /prescription, dental and vision insurance; health and dependent care ... At Virtua Health , we exist for one reason - to...in South Jersey, exceptional care is all around. Our medical and surgical experts are among the best in… 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 ... experience, preferably in the healthcare industry. + **Active New Jersey Registered Nurse (RN) License required.** **Skills:** + Knowledge of managed care principles… 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 a high ... + Additional Licenses and Certifications Current active State license as a Registered Nurse , Nurse Practitioner, Physicians Assistant, Medical Physician, or… more
- Baystate Health (Springfield, MA)
- **Baystate Health , a nationally recognized leader in healthcare quality and safety, is looking for a Part Time Operations Associate/Cardiac Monitor Technician to ... OF WORKING WITH BAYSTATE!** + Excellent Compensation High-quality, low-cost medical , dental and vision insurance + Generous PTO -...but are not limited to mental, physical, and financial health + Pet, home, auto and personal insurance +… more
- Baystate Health (Springfield, MA)
- **Baystate Health , a nationally recognized leader in healthcare quality and safety, is looking for a Full Time Operations Associate to join our team in Springfield, ... OF WORKING WITH BAYSTATE!** + Excellent Compensation High-quality, low-cost medical , dental and vision insurance + Generous PTO -...but are not limited to mental, physical, and financial health + Pet, home, auto and personal insurance +… 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 ... documentation comprehensively represents the current health status of network patients against ever-changing risk adjusted models. Responsible for achieving improved… more
- Medical Mutual of Ohio (OH)
- Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million ... members through our high-quality health , life, disability, dental, vision and indemnity plans. We...data documentation, compilation, reconciliation, and research.Works directly external HEDIS/NCQA auditor to resolve any items on Issue Log. +… more
- Trinity Health (Livonia, MI)
- …Maintains productivity standards Maintains compliance with regulatory requirements Assist Nurse Auditor and/or Coordinator with denial coordination process; ... Revenue Integrity colleagues including areas of opportunity. As a mission-driven innovative health organization, we will become the national leader in improving the … more
- Excellus BlueCross BlueShield (Dewitt, NY)
- …Work, Behavioral Health , Respiratory Therapy, Registered Dietitian, Registered Nurse , Medical Director, Pharmacist, Geriatrics, etc.) to ensure continuity ... activities in accordance with departmental, corporate, NYS Department of Health (DOH), Centers for Medicaid & Medicare Services (CMS),...NYS DOH, CMS, NCQA, and HEDIS, serving as internal auditor within the group. + Responsible for all aspects… more