- Humana (Jackson, MS)
- …guidelines/procedures. **Use your skills to make an impact** **Required Qualifications** + Active Registered Nurse license in a state that is part of the ... community and help us put health first** The Compliance Nurse 2 reviews utilization management activities and documentation to...remote environment + Minimum of three, (3), years varied clinical nursing experience. + Minimum of one, (1), year… more
- Henry Ford Health System (Troy, MI)
- …with department standards regarding productivity and audit quality. CERTIFICATIONS/LICENSURES REQUIRED: Registered Nurse credentialed from the Michigan Board of ... accuracy of billing through verification of coding, billing and supporting clinical documentation. Coordinates all activities associated with insurance carrier audit… more
- Northwell Health (Westbury, NY)
- …five (5) years of job entry date. + Current License to practice as a Registered Professional Nurse in New York State required, plus specialized certifications as ... a HCS-D - Home Care Coding Specialist-Diagnosis, COS-C Certificate for OASIS Specialist- Clinical . Conducts Home Health Resource Group (HHRG) Validation to ensure the… more
- 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 ... HCS-D - Home Care Coding Specialist-Diagnosis, COS-C Certificate for OASIS Specialist- Clinical . Job Responsibility 1.Leverages clinical expertise to identify and… 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 ... focus audits and reports findings. + Serves as a clinical resource for coding / denial management and customer...AND/OR CERTIFICATIONS + Current Virginia state license as a Registered Nurse or Registered … more
- Trinity Health (Newtown, PA)
- **Employment Type:** Full time **Shift:** **Description:** **Position Purpose:** The **R** **evenue Integrity Nurse Auditor ** is a Registered Nurse (RN) ... RN integrates the art, science, leadership & knowledge of nursing clinical practice through relationship-centered, compassionate, ethical & respectful direct /… more
- Elevance Health (Costa Mesa, CA)
- …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** **Virtual:** This role...are preferred: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Clinical … more
- Trinity Health (Ann Arbor, MI)
- …travelling between locations within the region. **MINIMUM QUALIFICATIONS** **Licensure/Certification:** Registered Nurse or Licensed Vocational Nurse / ... Patient Business Service (PBS) center and ensures compliant and complete clinical documentation, assists with denials and related audits, and identifies… more
- UNC Health Care (Chapel Hill, NC)
- …Association) certification - AAPC (American Academy of Professional Coders) certification - RN ( Registered Nurse ) license - LPN (Licensed Practical Nurse ) ... across the state to train and shadow round with Clinical Documentation Specialists. The CDS auditor provides elbow to elbow support during training and education… more
- Cleveland Clinic (Cleveland, OH)
- …future caregiver include: + Bachelor's or Associate's Degree in Business Administration + Registered Nurse (RN), Licensed Practical Nurse (LPN) or Certified ... continues to increase. This is where the Medical Chart Auditor on our team will step in. A caregiver...them. + Provide feedback to Reimbursement Managers, Institutes and Clinical areas resolving any issues uncovered during the reviews.… more
- Molina Healthcare (Phoenix, AZ)
- …current Licensure under the Arizona State Board of Nursing (BON) + QM BH Nurse : Arizona-licensed registered nurse practitioner licensed as an adult, ... Monitors and ensures that key quality activities that involve clinical decision-making are completed on time and accurately to...psychiatric and mental health nurse , or Arizona-licensed registered nurse … more
- R1 RCM (Chicago, IL)
- …to ensure internal and external compliance deadlines are met. **Required Skills:** + Active Registered Nurse license + An active CCS, RHIA, RHIT, CCA, CPC-A, ... encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Clinical Coding Appeals Nurse ** , you will help review and… more
- Fairfax County Sheriff's Office (Fairfax, VA)
- …Licensed Marriage and Family Therapist, Licensed Substance Abuse Treatment Practitioner or Clinical Nurse Specialist. + In addition, to recognize and reinforce ... given for qualified bi-lingual employees. + The CSB provides clinical supervision for employees who are registered ...Possession of a current license to practice as a Registered Nurse in the Commonwealth of Virginia… more
- Ascension Health (Wichita, KS)
- …are seeking an experienced Registered Nurse (RN) or Coding Auditor with strong knowledge in ambulatory clinical documentation integrity (CDI) and ... prior to hire date or job transfer date. + Registered Nurse obtained prior to hire date...join our team. This role is ideal for a nurse /coder who understands both clinical care and… more
- The Cigna Group (Sacramento, CA)
- …duties as required and related to this role. **Minimum requirements:** + Active unrestricted Registered Nurse (RN) license in state or territory of the United ... **Job Description Summary** Provides advanced professional input to complex Nurse Case Management assignments/projects. Plans, implements, and evaluates appropriate… more
- CommonSpirit Health Mountain Region (Lakewood, CO)
- …patient care including nurses, surgical technologist, surgeons, anesthesiologists, certified registered nurse anesthetists (CRNA), support specialists, unit ... open communication skills, be hard-working, dedicated and accountable. Job Summary: The clinical auditor performs clinical and operational audits as… more
- Baystate Health (Springfield, MA)
- …**10)** Observes cardiac monitors. Identifies and reports irregular rhythms to a registered nurse for interpretation and intervention. Records and processes EKG ... C Word, OA Gold, SMS, CIS, Premise, BMD, PCM Auditor , People Soft and Staples, and Kronos access if...clinical team inquiry. In coordination with the charge nurse , prepare staffing assignments for the next shift. Place… more
- Access Dubuque (Dubuque, IA)
- …**Job ID:** 156990 **Overview** As a member of the interdisciplinary team, the Registered Nurse (RN) contributes professional nursing knowledge and skills in the ... career and make a difference with UnityPoint Health. **Responsibilities** ** Clinical Excellence/Patient Care** + Assesses the needs of patients...Current licensure in good standing to practice as a Registered Nurse in Iowa . Must possess… more
- Excellus BlueCross BlueShield (Rochester, NY)
- … clinical expertise (ex. Social Work, Behavioral Health, Respiratory Therapy, Registered Dietitian, Registered Nurse , Medical Director, Pharmacist, ... drivers. Essential Accountabilities: Level I + Handles physical health member clinical management programs. + Maintains knowledge of current Case Management Society… more
- AdventHealth (Altamonte Springs, FL)
- …**LICENSURE, CERTIFICATION OR REGISTRATION REQUIRED:** . Current active State license as a Registered Nurse , Nurse Practitioner, or Physician's Assistant . ... FL **The role you will contribute:** Under general supervision of the Clinical Documentation Integrity (CDI) Manager, and in some situations the supervision of… more