- Intermountain Health (Springfield, IL)
- …To review medical records retrieved from provider offices and abstract medical information for HEDIS (Health Effectiveness Data Information Set) annual audits. ... Interprets relevant clinical criteria through review of medical records annotates via Adobe PDF and populates a data collection tool to support compliance with HEDIS, CMS, and STARS performance measures. **Job Essentials** + Work collaboratively with Select… more
- Carle Health (Champaign, IL)
- …of areas with suspected or confirmed problems. Qualifications Certifications: Licensed Registered Professional Nurse (RN) - Illinois Department of Financial ... revenue variance, and collaboration with operational areas. For Observation accounts, auditor is responsible for analyzing number of hours charged and whether… more
- 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)** **Virtual:** This...One or more of the following certifications are preferred: Registered Health Information Technician (RHIT), Registered Health… more
- Health Care Service Corporation (Quincy, IL)
- …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.** \#LI-Remote \#LI-DP1… more