• The CKHobbie Group (Harrisburg, PA)
    Job Description Position Overview: We are seeking a Registered Nurse (RN) to review and evaluate medical necessity, appropriateness, quality, and compliance of ... analysis, provider audits, fraud detection, and regulatory enforcement to ensure compliance with state and federal regulations. Key Responsibilities: Analyze claims… more
    Upward (07/03/25)
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  • Texas Health and Human Services Commission (Waco, TX)
    …at Texas State Auditor 's Office - Job Descriptions. ADA Accommodations: In compliance with the Americans with Disabilities Act (ADA), HHSC and DSHS agencies will ... the Benefits of Working at HHS webpage. Functional Title: Nurse III - HCSSA (Long-Term Care Regulation) Job Title:...Texas home health agencies and hospices to assess their compliance with state and federal laws and rules. This… more
    Upward (07/12/25)
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  • Texas Health and Human Services Commission (Brenham, TX)
    …at Texas State Auditor 's Office - Job Descriptions. ADA Accommodations: In compliance with the Americans with Disabilities Act (ADA), HHSC and DSHS agencies will ... the Benefits of Working at HHS webpage. Functional Title: Graduate - Licensed Vocational Nurse II Job Title: Licensed Vocational Nurse II Agency: Health & Human… more
    Upward (07/24/25)
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  • Optum (San Juan, PR)
    …Investigate and pursue recoveries Ensure adherence to state and federal compliance policies, reimbursement policies, and contract compliance Use pertinent ... - 10% Keep up required Coding Certificate and/or Nursing Licensure Complete compliance hours as required by the department ENGLISH PROFICIENCY ASSESSMENT WILL BE… more
    Upward (07/24/25)
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  • Texas Health and Human Services Commission (San Antonio, TX)
    …at Texas State Auditor 's Office - Job Descriptions. ADA Accommodations: In compliance with the Americans with Disabilities Act (ADA), HHSC and DSHS agencies will ... and registry checks including the Client Abuse/Neglect Reporting System (CANRS), Nurse Aid, Medication Aide and Employee Misconduct, List of Excluded… more
    Upward (07/13/25)
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  • Revenue Integrity Nurse Auditor

    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
    Childrens Hospital of The King's Daughters (07/24/25)
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  • Compliance Auditor , Intermediate…

    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 (07/11/25)
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  • Billing Compliance Auditor (RN)

    Elara Caring (Fort Worth, TX)
    …Time, in the Right Place. **Job Description:** **REMOTE POSITION** The Billing Compliance Auditor performs comprehensive audits within the Skilled Home Health, ... billing, coding, and clinical documentation. Duties of the Billing Compliance Auditor include but are not limited...Nursing + 5 years of experience as a Registered Nurse in Home Health and/or Hospice with coding experience… more
    Elara Caring (07/09/25)
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  • Compliance Auditor , Associate

    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
    UPMC (07/24/25)
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  • Compliance Auditor , Intermediate…

    UPMC (Wexford, PA)
    …be their best selves? UPMC Children's Community Pediatrics is hiring a Full-Time Compliance Auditor , Intermediate to support the office Remotely. Must live in ... claims processing, data collection, and quality reporting. + Conduct audits on other compliance related topics as determined to evaluate compliance with the… more
    UPMC (06/29/25)
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  • (RN) Registered Nurse Coding Auditor

    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
    Northwell Health (07/11/25)
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  • (RN) HCS-D, COS-C - Registered Nurse Coding…

    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 (06/02/25)
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  • Senior IT Auditor

    Access Dubuque (Dubuque, IA)
    …IT Auditor will collaborate with cross-functional teams to ensure compliance with regulatory standards and identify opportunities for process improvement **This ... Senior IT Auditor **McGraw Hill** 1 Positions ID: 5661 Posted...a strong understanding of IT governance, risk management, and compliance frameworks, with a particular emphasis on financial reporting… more
    Access Dubuque (07/10/25)
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  • Clinical Documentation Specialist Auditor

    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
    UNC Health Care (04/29/25)
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  • Clinical Auditor RN - Hybrid

    Baylor Scott & White Health (Dallas, TX)
    …position type and/or level **Job Summary** In this job, as a Clinical Auditor RN, you'll perform charge capture accuracy audits by reviewing and analyzing clinical ... audit tasks in clinical departments/functions. + Evaluate clinical documentation for compliance , meeting all regulations stipulated by federal and state agencies as… more
    Baylor Scott & White Health (07/18/25)
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  • RN PRN Surgery Chart Auditor

    Community Health Systems (Huntsville, AL)
    **Job Summary** The Registered Nurse (RN) provides patient-centered care through the nursing process of assessment, diagnosis, planning, implementation, and ... for patients and staff. + Participates in audits, chart reviews, and compliance checks to ensure adherence to standards of practice and regulatory requirements.… more
    Community Health Systems (07/02/25)
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  • Revenue Cycle Clinical Review Nurse

    UPMC (Pittsburgh, PA)
    …grow your career? UPMC is hiring a full-time Revenue Cycle Clinical Review Nurse . This position works Monday through Friday during daylight hours. Additionally, this ... position is eligible to work from home. The Revenue Cycle Clinical Review Nurse provides support to the local care management departments by initiating the… more
    UPMC (07/24/25)
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  • RN Clinical Review Appeals Specialist

    St. Luke's University Health Network (Allentown, PA)
    …coding determination made by the government or commercial payors, or their auditor representative. + Facilitate clinical chart reviews to assist with supporting ... + Participate in Administrative Law Judge (ALJ) hearings and/or formal meetings with auditor or payor representatives in defense of coding appeals, as needed. +… more
    St. Luke's University Health Network (07/08/25)
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  • System CDI Quality Team Leader Educator

    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
    AdventHealth (06/06/25)
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  • System Accreditation Specialist

    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
    Houston Methodist (07/04/25)
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