- Molina Healthcare (Spokane, WA)
- The Clinical Services Auditor performs auditing of clinical staff in Utilization Management (UM), Case Management (CM), Member Assessment Team (MAT), ... WA RN licensure required **KNOWLEDGE/SKILLS/ABILITIES** + Performs monthly auditing of registered nurse and other clinical functions in Utilization… more
- Mount Sinai Health System (New York, NY)
- …at all levels throughout the organization. **License** ? Current NYS licensure ( Registered Nurse ( RN ), Occupational Therapist (OT), Physical Therapist ... **Job Description** ** Clinical Revenue Auditor -CDM Patient Financial Services -Corporate-Full-Time-Days-Option to work remote or hybrid.** The Clinical … more
- UNC Health Care (Chapel Hill, NC)
- …Association) certification - AAPC (American Academy of Professional Coders) certification - RN ( Registered Nurse ) license - LPN (Licensed Practical ... are owned or managed that have opted into shared services . This position reports to the HCS Supervisor Coding...across the state to train and shadow round with Clinical Documentation Specialists. The CDS auditor provides… more
- AdventHealth (Tampa, FL)
- …be adaptable and flexible as required. Regional Travel up to 20% may be required. Registered Nurse ( RN ) Florida Required This facility is an equal ... cardiovascular medicine, neuroscience and neurology, digestive health, orthopedics, womens services , pediatrics, oncology, endocrinology, bariatrics, wound healing, sleep medicine… 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 ... **Req Number** 128397 Job Description Seeking RN - BSN or MSN candidates with a...- Home Care Coding Specialist-Diagnosis, COS-C Certificate for OASIS Specialist- Clinical . Conducts Home Health Resource Group (HHRG) Validation to… more
- Northwell Health (Westbury, NY)
- …combination of education and related experience. 2.Current License to practice as a Registered Professional Nurse in New York State required, plus specialized ... the assignment can be substantiated by the documentation in the Medical Record. Seeking RN - BSN or MSN candidates with a HCS-D - Home Care Coding… more
- AdventHealth (Tampa, FL)
- …with physician orders, clinical documentation and reports. The Nurse Auditor will work closely with Financial Services and the Patient Accounting ... to this position by HIM, PFS, Customer Service or case management. The Nurse Auditor will work closely with the FH/Managed Care department anytime there are… more
- US Tech Solutions (Newark, NJ)
- …of related experience, preferably in the healthcare industry. + **Active New Jersey Registered Nurse ( RN ) License required.** **Skills:** + Knowledge of ... months contract with potential extends or Convert** **Job Description:** + The HEDIS Nurse Auditor is responsible for conducting quality audits related to state… more
- Humana (Corpus Christi, TX)
- …as needed. Requires applicable State licensure in field of study: Registered Nurse ( RN ), Licensed Masters Clinical Social Worker (LCSW), Licensed Masters ... 1 supports and implements programs to establish high quality standards in clinical products and services . Support, develop and operationalize methods to… more
- AdventHealth (Orlando, FL)
- …+ RN current valid State of Florida or multi state license as a Registered Nurse **or** + CST, Certified Surgery Technician (CST) from the National Board of ... outpatients each year **The role you'll contribute:** The Surgical and Procedural Services Safety and Regulatory Compliance Auditor evaluates the surgical 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 ... compliance with billing regulations and trends in denials of services due to medical necessity or appropriateness of ...AND/OR CERTIFICATIONS + Current Virginia state license as a Registered Nurse or Registered … more
- Insight Global (South Jordan, UT)
- …terminology. Expert coding knowledge (DRG & ICD-10) Registered Nurse RN (must be inpatient) WITH coding/ clinical documentation certification (2 years in ... Job Description Insight Global is seeking a DRG Validation Auditor for one of our clients to sit 100%...clinical documentation) OR IF NOT A NURSE : Degree in RHIM, RHIA, RHIT with medical coding… more
- Actalent (Atlanta, GA)
- …findings, including clinical recommendations to assure the delivery of quality services . + Lead case reviews to assess the clinical performance provided ... Job Title: Quality Improvement Auditor - Fully remote Job Description The Quality... will lead medical record audits, monitor and analyze clinical documentation, and modify business processes to measure member… more
- Catholic Health Initiatives (Chattanooga, TN)
- …to include review, education and necessary follow-up to help ensure that clinical documentation and coding services meet government and organizational policies ... Management Service Organization (MSO) that provides comprehensive office management services for all Memorial Health Partners and many physicians in private… more
- BayCare Health System (Raleigh, NC)
- …and Licensures + **Required:** RHIA/RHIT in conjunction with CCS + **Preferred:** RN , CDIP, CCDS, or clinical degree Education + **Required:** associate's ... Team Member who is passionate about providing outstanding customer service to our community. We are looking for an...PM + **Days:** Monday - Friday The Inpatient Coding Auditor is a full-time remote position. _Sign on bonuses… more
- 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 ... ICD-10-CM/PCS coding, DRG assignments, and supporting clinical documentation. This includes evaluating present on admission (POA)...any other relevant data to ensure coding accuracy. The auditor is also responsible for writing and defending appeal… more
- Trinity Health (Ann Arbor, MI)
- …travelling between locations within the region. **MINIMUM QUALIFICATIONS** **Licensure/Certification:** Registered Nurse or Licensed Vocational Nurse / ... Business Service (PBS) center and ensures compliant and complete clinical documentation, assists with denials and related audits, and identifies opportunities… more
- Excellus BlueCross BlueShield (Rochester, NY)
- … clinical expertise (ex. Social Work, Behavioral Health, Respiratory Therapy, Registered Dietitian, Registered Nurse , Medical Director, Pharmacist, ... All Levels + Associates degree required. Bachelor's degree preferred. + Active NYS RN or Registered Dietician or Physical Therapist licensure required. + Minimum… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …and represents non- clinical staff in discussions with Medical Directors and/or clinical consultants. + Serves as an internal auditor /peer reviewer for new ... + Current NYS RN license with a minimum of three years clinical experience; medical/surgical background preferred. + Current CPC designation or must obtain CPC… more
- University of Texas Rio Grande Valley (Harlingen, TX)
- …Medicine/ Revenue Cycle FTE1.0 FLSAExempt Scope of Job To promote appropriate clinical documentation through collaboration with the School of Medicine clinical ... process is followed. Description of Duties * Obtains and promotes appropriate clinical documentation through interaction with clinical staff and physicians to… more