- 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
- 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 ... each position may vary based on geographical location. **Category:** Quality / Clinical Effectiveness **Organization:** AdventHealth Tampa **Schedule:** Full-time… 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 ... and efficiency recommendations. **Minimum Requirements:** + Requires current, active, unrestricted Registered Nurse license in applicable state(s). + Requires a… 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
- AdventHealth (Orlando, FL)
- …role you'll contribute:** The Clinical Documentation Integrity Manager is a Registered Nurse and/or a Registered Health Information Administrator with ... + Additional Licenses and Certifications Current active State license as a Registered Nurse , Nurse Practitioner, Physicians Assistant, Medical Physician,… 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
- 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
- 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 ... contract to Convert** **Job Description:** + This position is responsible for conducting quality audits for state audits, HEDIS and quality referral and… 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
- 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
- Excellus BlueCross BlueShield (Dewitt, NY)
- … clinical expertise (ex. Social Work, Behavioral Health, Respiratory Therapy, Registered Dietitian, Registered Nurse , Medical Director, Pharmacist, ... quality health care services. Examples may include: Utilization Management, Quality , Behavioral Health, Pharmacy, Registered Dietitian and Respiratory… more
- Molina Healthcare (El Paso, TX)
- …Specialist, Member & Community Interventions oversees and implements new and existing clinical quality member intervention initiatives including all lines of ... between other departments within the organization + Supports provision of high- quality clinical care and services by facilitating/building strategic… more
- University of Texas Rio Grande Valley (Harlingen, TX)
- …Medicine/ Revenue Cycle FTE1.0 FLSAExempt Scope of Job To promote appropriate clinical documentation through collaboration with the School of Medicine clinical ... process is followed. Description of Duties * Obtains and promotes appropriate clinical documentation through interaction with clinical staff and physicians to… more
- Molina Healthcare (St. Petersburg, FL)
- …audit experience. **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:** * Certified Professional in Health Quality (CPHQ) * Nursing License ( RN may be preferred for ... **Job Description** **Job Summary** The Director, Clinical Data Acquisition is responsible for the implementation,...deliverables. This role also works with the Health Plan quality leads to strategically plan for supplemental data source… more
- NCH (Naples, FL)
- …Integrity Specialist for educational opportunities/outcomes. * Collaborates with CDI liaison/ quality auditor when educational needs are identified from ... together. Visit nchjobs.org to learn more. JOB SUMMARY The Quality Improvement Clinical Documentation Integrity Specialist (QI-CDIS)...Degree required; Bachelor's Degree preferred. * Licensed as a Registered Nurse in the state of Florida.… more
- AdventHealth (Altamonte Springs, FL)
- …including attending physicians, allied health practitioners, nursing, care management and quality abstracters. The Quality Auditor Manager adheres ... **LICENSURE, CERTIFICATION OR REGISTRATION REQUIRED:** . Current active State license as a Registered Nurse , Nurse Practitioner, or Physician's Assistant .… more
- Baystate Health (Springfield, MA)
- …**10)** Observes cardiac monitors. Identifies and reports irregular rhythms to a registered nurse for interpretation and intervention. Records and processes EKG ... communication with NEOPO and related paperwork in conjunction with RN . Screen calls for the clinical team...clinical team inquiry. In coordination with the charge nurse , prepare staffing assignments for the next shift. Place… more
- Houston Methodist (Houston, TX)
- …in nursing or other healthcare related field; may consider HM employee with Registered Nurse license and four additional years of directly related experience ... or health care certifications **OR** + CQA - Certified Quality Auditor (ASQ) -- Related quality...accreditation or health care certifications **OR** + RHIA - Registered Health Information Administrator (AHIMA) -- Related quality… more
- Baystate Health (Springfield, MA)
- …appropriate, coordinates communication with NEOPO and related paperwork in conjunction with RN . Screen calls for clinical team and facilitates communication of ... **Baystate Health, a nationally recognized leader in healthcare quality and safety, is looking for a Full...forms, etc. **8)** Unit Resource: Post/file MD schedules for clinical team inquiry. In coordination with charge nurse… more