- 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 (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 HCS-D - Home Care Coding Specialist-Diagnosis, COS-C Certificate for OASIS… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …varied clinical expertise (ex. Social Work, Behavioral Health, Respiratory Therapy, Registered Dietitian, Registered Nurse , Medical Director, Pharmacist, ... NYS DOH, CMS, NCQA, and HEDIS, serving as internal auditor within the group. + Responsible for all aspects...Associates degree required. Bachelor's degree preferred. + Active NYS RN or Registered Dietician or Physical Therapist… more
- Elevance Health (Gilbert, MN)
- …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
- 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
- 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
- Molina Healthcare (Bronx, NY)
- …and/or managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... in state of practice. * Strong attention to detail and organizational skills. * Strong analytical and problem-solving skills. * Ability to work in a cross-functional, professional environment. * Ability to work on a team and independently. * Excellent verbal… more
- UPMC (Pittsburgh, PA)
- …Registered Health Information Technician (RHIT) + OR Licensed Professional Nurse (LPN) + Registered Nurse ( RN ) Required: + Act 34 **UPMC is an Equal ... **Join UPMC Corporate Compliance as an Intermediate Compliance Auditor !** Are you passionate about ensuring accuracy and...Registered Health Information Administrator (RHIA) + … more
- UPMC (Pittsburgh, PA)
- …Registered Health Information Technician (RHIT) + Licensed Professional Nurse (LPN) or + Registered Nurse ( RN ) + Act 34 **UPMC is an Equal Opportunity ... **Join UPMC Corporate Finance as a Compliance Auditor , Associate!** Are you detail-oriented and passionate about...Finance** is looking for a dedicated and meticulous **Compliance Auditor , Associate** to join our team. This role is… more
- Humana (Corpus Christi, TX)
- …process management as needed. Requires applicable State licensure in field of study: Registered Nurse ( RN ), Licensed Masters Clinical Social Worker (LCSW), ... accuracy, and Medicare Conditions of Participation demand meticulous documentation. A QA Auditor will help ensure all records meet federal, state, and payer-specific… more
- Elara Caring (Dallas, TX)
- …+ Associate's degree or higher in Nursing + 5 years of experience as a Registered Nurse in Home Health and/or Hospice with coding experience is preferred + ... Right Time, in the Right Place. **Job Description:** The Billing Compliance Auditor performs comprehensive audits within the Skilled Home Health, Hospice, Behavioral… more
- Insight Global (South Jordan, UT)
- …medical necessity criteria, and coding terminology. Expert coding knowledge (DRG & ICD-10) Registered Nurse RN (must be inpatient) WITH coding/clinical ... 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
- CVS Health (Phoenix, AZ)
- …and scoring guidelines. + Participates in QM meetings. **Required Qualifications** + Active RN ( Registered Nurse ) or LPN (Licensed Practical Nurse ... heart, each and every day. **Position Summary** The **Healthcare Quality Management Auditor ** participates in the development and ongoing implementation of QM (… more
- 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
- Health Care Service Corporation (Richardson, TX)
- …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
- Henry Ford Health System (Detroit, MI)
- …Intervention (CI) or Vascular Interventional (VI) or license to practice as a registered nurse in the state of Michigan. * BLS/ACLS. Additional Information ... a Cardiac Cath Lab Tech II or in a registered nursing role in the Cath/EP lab. PRINCIPLE DUTIES...a Cardiac Cath Lab Tech II or in a registered nursing role in the Cath/EP lab. Location: Detroit… more
- Providence (Portland, OR)
- …Texas, New Mexico, Idaho, or Montana **Job Description:** The Clinical Documentation Specialist, Registered Nurse ( RN ) is responsible for quality review of ... must empower them. **Required Qualifications:** + Education sufficient for licensure. + Oregon Registered Nurse License upon hire. + Must be licensed in states… more
- 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
- Molina Healthcare (IA)
- …related field or equivalent experience, OR completion of any of the following programs: + Registered Nurse ( RN ) or State Licensed Vocational Nurse (LVN), ... OR completion of any of the following programs: + Registered Nurse ( RN ) or State...be preferred for specific roles) * Certified HEDIS Compliance Auditor (CHCA) **PHY** **S** **I** **C** **AL DEM** **A**… 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 ... be applicable to this role.** **Summary:** **Reports to the Nurse Manager but daily activities are coordinated by the...for discharge orders and follows up with MD, CM RN to assure discharge documents are complete. Enters discharges… more