- 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 ... AND/OR CERTIFICATIONS + Current Virginia state license as a Registered Nurse or Registered Nurse holding a valid Compact State license. + Certified Professional… more
- MD Anderson Cancer Center (Houston, TX)
- As a * Nurse Defense Auditor * in our *Hospital Billing & Collections* department, your expertise ensures accurate reimbursement and supports patient access to ... wellness programs, employee discounts, and more The primary purpose of the * Nurse Defense Audit Coordinator* position within the *Hospital Billing & Collections… 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
- Northwell Health (Glen Cove, NY)
- …and related experience. 2.Current License to practice as a Registered Professional Nurse in New York State required, plus specialized certifications as needed. 3. ... Rehab nursing experience, preferred. 4. ICD-10 medical coding experience, highly preferred. *Additional Salary Detail The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful… more
- Banner Health (AZ)
- …employment settings by including remote and hybrid opportunities. As a **Licensed Practical Nurse (LPN)** for **Banner Health Plans** , you will be an integral part ... of the **Health Plan Medical Management Team** . This assignment-based role focuses on independent chart review and clinical assessment. **Key Responsibilities** : + Independently review patient medical charts to assess whether the care provided may have… more
- Trinity Health (Livonia, MI)
- …to intra-departmental Revenue Integrity colleagues including areas of opportunity. Assist Nurse Auditor and/or other stakeholders with denial related charge ... RHIA, RHIT, CCS, CPC/COC or other coding credentials _and/or Licensed Vocational Nurse / Licensed Practical Nurse licensure_ is required. CHC (Healthcare… more
- UPMC (Pittsburgh, PA)
- **Join UPMC Corporate Compliance as an Intermediate Compliance Auditor !** Are you passionate about ensuring accuracy and compliance in healthcare documentation and ... **UPMC Corporate Compliance** is seeking a dedicated and detail-oriented **Intermediate Compliance Auditor ** to join our team! This position will be based out of… more
- Robert Half Accountemps (Boston, MA)
- Description Job Title: Medical Claims Auditor - RN Auditor Location: Massachusetts - 90% Remote Job Type: 1 Year Contract - Potential for Perm Hire Hours: 40 ... Start Date: December 1, 2025 Job Description We are seeking a qualified Auditor with healthcare experience to support Program Integrity activities for a state… more
- BJC HealthCare (St. Louis, MO)
- …collaborating within a team setting? BJC Home Care is looking for an licensed practical nurse Scheduler, auditor and field visits to assist our patients and our ... within the scope of practice for the Licensed Practical Nurse . + Under the direction of the Registered ...Nurse . + Under the direction of the Registered Nurse , provides patient teaching and discharge planning. Participates in… more
- Providence (MT)
- …must empower them._** **Providence Health Plan is calling a Coding Quality Auditor , HEDIS who will:** + Be responsible for conducting clinical quality ... Seasonal Role:_** + **This posting is for multiple openings of a Coding Quality Auditor , HEDIS** + **This position is affiliated with Providence Health Plan and will… more
- Elevance Health (Washington, DC)
- **Diagnosis Related Group Clinical Validation Auditor -RN (CDI, MS-DRG, AP-DRG and APR-DRG)** **Virtual:** This role enables associates to work virtually full-time, ... granted as required by law. The **Diagnosis Related Group Clinical Validation Auditor ** is responsible for auditing inpatient medical records to ensure clinical… more
- CVS Health (Phoenix, AZ)
- …heart, each and every day. **Position Summary** The **Healthcare Quality Management Auditor ** participates in the development and ongoing implementation of QM ( ... in QM meetings. **Required Qualifications** + Active RN (Registered Nurse ) or LPN (Licensed Practical Nurse ) license, valid in the state of Arizona. + 1+… more
- AdventHealth (Orlando, FL)
- …The Surgical and Procedural Services Safety and Regulatory Compliance Auditor evaluates the surgical and procedural environment, policies, and procedures ... Florida or multi state license as a Licensed Practical Nurse **or** + RN current valid State of Florida...of Florida or multi state license as a Registered Nurse **or** + CST, Certified Surgery Technician (CST) from… more
- Insight Global (South Jordan, UT)
- Job Description Insight Global is seeking a DRG Validation Auditor for one of our clients to sit 100% remote. This person should have an extensive background in ... and coding terminology. Expert coding knowledge (DRG & ICD-10) Registered Nurse RN (must be inpatient) WITH coding/clinical documentation certification (2 years… 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 ... (American Academy of Professional Coders) certification - RN (Registered Nurse ) license - LPN (Licensed Practical Nurse )...(Registered Nurse ) license - LPN (Licensed Practical Nurse ) license - Advance Practice Provider (NP or PA)… more
- Centene Corporation (Jefferson City, MO)
- …RESIDE IN MISSOURI **Ideal candidate will be a Licensed Practical Nurse (LPN) with auditing experience.** **Education/Experience:** Bachelor's degree in related ... Mental Health Counselor (LMHC), Licensed Professional Counselor (LPC), Registered Nurse (RN), or Licensed Practical Nurse (LPN)...(LPC), Registered Nurse (RN), or Licensed Practical Nurse (LPN) Pay Range: $55,100.00 - $99,000.00 per year… 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 ... Additional Licenses and Certifications Current active State license as a Registered Nurse , Nurse Practitioner, Physicians Assistant, Medical Physician, or an… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Social Work, Behavioral Health, Respiratory Therapy, Registered Dietitian, Registered Nurse , Medical Director, Pharmacist, Geriatrics, etc.) to ensure continuity and ... are being met, such as NYS DOH, CMS, NCQA, and HEDIS, serving as internal auditor within the group. + Responsible for all aspects of the Case Management department… more
- Baystate Health (Springfield, MA)
- …incentive payments that may be applicable to this role.** **Summary:** **Reports to the Nurse Manager but daily activities are coordinated by the charge nurse . ... required telemetry training course.** **Summary** : Reports to the Nurse Manager, but daily activities are coordinated by the...C Word, OA Gold, SMS, CIS, Premise, BMD, PCM Auditor , People Soft and Staples, and Kronos access if… more
- Baystate Health (Springfield, MA)
- …payments that may be applicable to this role.** **Summary** : Reports to the Nurse Manager, but daily activities are coordinated by the charge nurse . ... ADTs. Checks BMD enters new data and advises Charge Nurse of changes. Checks CIS for discharge orders and...C Word, OA Gold, SMS, CIS, Premise, BMD, PCM Auditor , People Soft and Staples, and Kronos access if… more
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