• ( RN ) Registered Nurse

    Northwell Health (Garden City, NY)
    …combination of education and related experience. 2.Current License to practice as a Registered Professional Nurse in New York State required, plus specialized ... can be substantiated by the documentation in the Medical Record. Seeking RN candidates with a HCS-D - Home Care Coding Specialist-Diagnosis, COS-C Certificate… more
    Northwell Health (11/21/25)
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  • Diagnosis Related Group Clinical Validation…

    Elevance Health (Chicago, IL)
    …and efficiency recommendations. **Minimum Requirements:** + Requires current, active, unrestricted Registered Nurse license in applicable state(s). + Requires a ... **Diagnosis Related Group Clinical Validation Auditor - RN (CDI, MS-DRG, AP-DRG and APR-DRG)**...One or more of the following certifications are preferred: Registered Health Information Technician (RHIT), Registered Health… more
    Elevance Health (12/17/25)
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  • Cardiovascular Services RN Auditor

    Trinity Health (Fresno, CA)
    …or combination of equivalent experience and education is required. 2. Current licensure as a Registered Nurse ( RN ) with the state of California is required. ... Reporting to the Nurse Manager*, Cath Lab, the Nurse Auditor performs thorough chart review of Electronic Medical Records (EMR) documentation… more
    Trinity Health (12/08/25)
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  • HEDIS RN - Quality Auditor

    US Tech Solutions (Newark, NJ)
    …of related experience, preferably in the healthcare industry. + **Active New Jersey Registered Nurse ( RN ) License required.** **Skills:** + Knowledge of ... contract with potential extends or Convert** **Job Description:** + The HEDIS Nurse Auditor is responsible for conducting quality audits related to state audits,… more
    US Tech Solutions (11/20/25)
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  • Nurse Auditor 2

    Humana (Springfield, IL)
    …each day between 6AM and 9AM in their home time zone. **Required Qualifications** + Active Registered Nurse ( RN ) license in the state they reside. + Minimum ... of our caring community and help us put health first** The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record… more
    Humana (12/11/25)
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  • Revenue Integrity Charge Auditor (Remote)

    Stanford Health Care (Palo Alto, CA)
    …billing practices. + Proficient EXCEL, WORD, PowerPoint skills **Licenses and Certifications** + RN - Registered Nurse - State Licensure And/Or Compact ... Stanford Health Care job.** **A Brief Overview** The Charge Auditor performs auditing activities, including complex cases that require...and + CPC required . or + RHIT - Registered Health Information Technician required . or + RHIA… more
    Stanford Health Care (12/10/25)
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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 ... as assigned. + LICENSES AND/OR CERTIFICATIONS + Current Virginia state license as a Registered Nurse or Registered Nurse holding a valid Compact State… more
    Childrens Hospital of The King's Daughters (10/23/25)
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  • DRG Auditor

    Insight Global (South Jordan, UT)
    …criteria, and coding terminology. * Expert coding knowledge (DRG & ICD-10) * Registered Nurse RN (must be inpatient) WITH coding/clinical documentation ... Job Description Insight Global is seeking a DRG Validation Auditor for one of our clients to sit 100%...(2 years in clinical documentation) OR IF NOT A NURSE : Degree in RHIM, RHIA, RHIT with medical coding… more
    Insight Global (12/09/25)
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  • Clinical Documentation Specialist Auditor

    UNC Health Care (Chapel Hill, NC)
    …Association) certification - AAPC (American Academy of Professional Coders) certification - RN ( Registered Nurse ) license - LPN (Licensed Practical ... 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
    UNC Health Care (10/28/25)
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  • Clinical Revenue Auditor -CDM Patient…

    Mount Sinai Health System (New York, NY)
    **Job Description** **Clinical Revenue Auditor -CDM Patient Financial Services-Corporate-Full-Time-Days- Hybrid.** The Clinical Revenue Auditor for the Mount ... organization. **Licensing and Certification Requirements** : + Current NYS licensure ( RN , OT, PT, SLP, PA, Social Worker, Laboratory Technologist, Radiological… more
    Mount Sinai Health System (09/24/25)
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  • DRG Denials Auditor

    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 ... any other relevant data to ensure coding accuracy. The auditor is also responsible for writing and defending appeal...and organizational skills. **Licenses and Certifications** + CRNP, LPN, RN , MD, PA, or DO preferred + CCS-Certified Coding… more
    Community Health Systems (12/09/25)
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  • Rev Integrity Auditor Sr

    Covenant Health Inc. (Knoxville, TN)
    Overview Revenue Integrity Auditor Full Time, 80 Hours Per Pay Period, Day Shift Covenant Health Overview: Covenant Health is the region's top-performing healthcare ... study or current clinical license/registration in the State of Tennessee as RN with equivalent coding experience. Apply/Share Job Title REV INTEGRITY AUDITOR more
    Covenant Health Inc. (11/14/25)
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  • Senior Healthcare Auditor

    University of Washington (Seattle, WA)
    …intellectual excitement, artistic pursuits, and natural beauty. The senior healthcare auditor is responsible for the completion of internal audits within the ... work performed and conclusions drawn so other reviewers can follow the auditor 's logic and methodology. . Effectively evaluates audit results, weighing the… more
    University of Washington (10/31/25)
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  • DRG Revenue Integrity Auditor

    Insight Global (Plano, TX)
    …working in an acute care setting or a third-party vendor as a DRG Auditor or Clinical Documentation Specialist (CDS). -CCS Certification RN or BSN RHIT or RHIA ... DRG Auditors to join a remote healthcare organization. The DRG Revenue Integrity Auditor will perform Diagnostic Related Group (DRG) validation and quality audits on… more
    Insight Global (10/30/25)
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  • Home Health Quality Auditor

    Humana (Corpus Christi, TX)
    …community and help us put health first** The Home Health Quality Auditor ensures clinical documentation meets CMS regulations, OASIS accuracy, and Medicare ... accuracy, and completeness, helping reduce audit risk and billing delays. The auditor monitors QA metrics, identifies trends, and collaborates with leadership to… more
    Humana (10/01/25)
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  • Coding Investigator Auditor

    Health Care Service Corporation (Tulsa, OK)
    …document findings.** **Organizational skills and prioritization skills** **Preferred Job Qualifications:** ** Registered Nurse ( RN ) with unrestricted license ... in state.** **Certified Coder preferred** **3 plus years of claim adjudication/payment integrity** **3 years clinical experience** **This is a Telecommute (Remote) role: Must reside within 250 miles of the office or anywhere within the posted state.**… more
    Health Care Service Corporation (12/19/25)
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  • Medical Management Auditor

    Centene Corporation (Jefferson City, MO)
    …Social Worker (LCSW), Licensed Mental Health Counselor (LMHC), Licensed Professional Counselor (LPC), Registered Nurse ( RN ), or Licensed Practical Nurse ... RESIDE IN MISSOURI **Ideal candidate will be a Licensed Practical Nurse (LPN) with auditing experience.** **Education/Experience:** Bachelor's degree in related… more
    Centene Corporation (12/05/25)
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  • Compliance Coding Auditor - Integrity…

    Guthrie (Sayre, PA)
    Option to be Hybrid/Remote. Summary: A senior level compliance coding auditor conducting assessments in accordance with The Guthrie Clinic's policies and procedures ... preferred Licenses/Certifications: + AHIMA (RHIA, RHIT, or CCS) or AAPC (CPC) required + RN /LPN or CPMA preferred + Required to sit for CPC exam within one year… more
    Guthrie (12/13/25)
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  • Health Plans Licensed Practical Nurse LPN…

    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 ... This position is also responsible for assisting the QM RN with the investigation and research of quality of...(CAPs), in collaboration with the Manager, Supervisor or QM RN and communicates audit results to providers along with… more
    Banner Health (11/27/25)
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  • RN Clinical Review Appeals Specialist

    St. Luke's University Health Network (Allentown, PA)
    …Works inside with adequate lighting, comfortable temperature and ventilation. EDUCATION: Registered Nurse required, BSN preferred. Current license required. . ... regardless of a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data… more
    St. Luke's University Health Network (10/28/25)
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