- 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, ... wide variety of claim types and identifying claims requiring further review. The Nurse Auditor will also maintain productivity goals, uphold quality standards,… more
- Actalent (West Des Moines, IA)
- Job Title: Nurse Auditor Job Description This role requires a thorough understanding of standard medical coding, including CPT, ICD-10, and HCPCS. The Nurse ... auditing and pricing a wide variety of claim types, and ensuring compliance with departmental and company policies. Responsibilities + Adjudicate claims to maintain… 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 ... timely manner. + Prepares trend and other reports for compliance audits and charge processes. + Serves as a...CERTIFICATIONS + Current Virginia state license as a Registered Nurse or Registered Nurse holding a valid… more
- UPMC (Pittsburgh, PA)
- **Join UPMC Corporate Compliance as an Intermediate Compliance Auditor !** Are you passionate about ensuring accuracy and compliance in healthcare ... **UPMC Corporate Compliance ** is seeking a dedicated and detail-oriented **Intermediate Compliance Auditor ** to join our team! This position will be based… more
- UPMC (Pittsburgh, PA)
- **Join UPMC Corporate Finance as a Compliance Auditor , Associate!** Are you detail-oriented and passionate about ensuring compliance in healthcare? **UPMC ... Corporate Finance** is looking for a dedicated and meticulous ** Compliance Auditor , Associate** to join our team....+ Registered Health Information Technician (RHIT) + Licensed Professional Nurse (LPN) or + Registered Nurse (RN)… more
- Northwell Health (Westbury, NY)
- …reviews Medicare/non-Medicare charts to ensure that proper standards are maintained in compliance with Federal and State regulations. + Applies coding rules and ... the validation review process. + Reviews codes on Medicare/non-Medicare charts for compliance to rules and conventions. + Instructs professional staff in code… more
- Northwell Health (Garden City, NY)
- …Medicare/non-Medicare charts to ensure that proper standards are maintained in compliance with Federal and State regulations. 5.Applies coding rules and regulations ... the validation review process. 6.Reviews codes on Medicare/non-Medicare charts for compliance to rules and conventions. 7.Communicates DRG changes and rationale to… more
- Robert Half Accountemps (Boston, MA)
- …administration, and compliance within the healthcare sector. The ideal RN Auditor candidate will play a critical role in ensuring program integrity through ... Description We are looking for a highly skilled RN Auditor to join our team in Boston, Massachusetts. This...onsite and desk audits of healthcare providers to ensure compliance with program integrity standards. * Analyze claims and… 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 ... Conduct on-site reviews at provider offices to assess record quality and compliance with documentation standards. + Prepare reports summarizing findings and provide… more
- UNC Health Care (Chapel Hill, NC)
- …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 ... all patients. Educates on proper creation of provider compliant queries. 8. Ensures compliance with third party and State and Federal regulations. 9. Audits CDS… 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 level ... team:** + Reviews concurrent and retrospective medical record for documentation compliance including completeness and accuracy for severity of illness (SOI), risk… 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 ... being processed appropriately. Responsible for developing, implementing and maintaining compliance plan for pro-fee coding and abstracting. Position Responsibilities:… more
- Trinity Health (Livonia, MI)
- …productivity standards Maintains compliance with regulatory requirements Assist Nurse Auditor and/or Coordinator with denial coordination process; including ... coding credentials and/or Licensed Vocational Nurse / Licensed Practical Nurse licensure is required. CHC (Healthcare Compliance Certification) preferred… more
- AdventHealth (Altamonte Springs, FL)
- …with physicians, nursing and HIM coders. The CDI Quality & Compliance Team Leader strategically facilitates and obtains appropriate and quality physician ... practitioners, nursing, care management and quality abstracters. The Quality Auditor Manager adheres to strict departmental and organizational goals, objectives,… more
- Medical Mutual of Ohio (OH)
- …To include data documentation, compilation, reconciliation, and research.Works directly external HEDIS/NCQA auditor to resolve any items on Issue Log. + Reviews data ... sources to ensure accuracy and validity in compliance with HEDIS technical specifications, policies and operating procedures....planning coordination and facilitation. Works with IT and Clinical Nurse staff to aid in the loading of HEDIS… more
- Houston Methodist (Houston, TX)
- …programs; works across the system to assess, measure, and report compliance with standards; and develops, implements and evaluates strategies to promote ... of evidence-based best practices and standardization to enhance system-wide compliance . **PEOPLE ESSENTIAL FUNCTIONS** + Collaborates and effectively communicates… more
- HCA Healthcare (San Antonio, TX)
- …true discrepancy and complete incident reports as required. You will review RX Auditor report and generate investigation reports for nurse managers/directors to ... hospital personnel politely and appropriately. You will perform and monitor compliance for quality control and performance improvement functions as assigned. You… more
- Ochsner Health (New Orleans, LA)
- …providers , on- site case management team, as well as LPN/RN or Nurse Auditor in the Pre-Service department. + Performs Pre-Service collection estimation ... apply to the assigned area of responsibility and ensures compliance with all such laws, regulations and standards. This...and standards. This employer maintains and complies with its Compliance & Privacy Program and Standards of Conduct, including… more
- Geo-Technology Associates, Inc. (Abingdon, MD)
- …cash flow, balance sheet). + Reconcile balance sheet accounts, resolving discrepancies. Compliance , Audit & Tax + Ensure compliance with financial regulations ... policies. + Prepare documentation for audits and respond to auditor inquiries. + Provide data for tax filings and...and more + Peak Health Wellness Plan - personalized nurse consultations, no-cost lab work, and ongoing wellness support… more
- Covenant Health Inc. (Knoxville, TN)
- …Covenant Health standards of Telephone Excellence policy. + Refers patient accounts to nurse auditor upon request by patient or insurance company, and monitors ... guidelines and other Third Party Payor requirements assuring departmental compliance . + Recognizes situations, which necessitate supervision and guidance, seeks… more