- Northwell Health (Glen Cove, NY)
- …combination of education and related experience. 2.Current License to practice as a Registered Professional Nurse in New York State required, plus specialized ... 2.Full review of CDI suggested code changes 3.Demonstrates comprehensive knowledge of coding guidelines and principals; performs coding audits for optimization.… 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 ... RN - BSN or MSN candidates with a HCS-D - Home Care Coding Specialist-Diagnosis, COS-C Certificate for OASIS Specialist-Clinical. Conducts Home Health Resource Group… more
- UNC Health Care (Chapel Hill, NC)
- …Association) certification - AAPC (American Academy of Professional Coders) certification - RN ( Registered Nurse ) license - LPN (Licensed Practical Nurse ) ... shared services. This position reports to the HCS Supervisor Coding and CDI Quality and Training. This position may...and shadow round with Clinical Documentation Specialists. The CDS auditor provides elbow to elbow support during training and… more
- Humana (Washington, DC)
- …a part of our caring community and help us put health first** The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record ... complete, compliant and accurate to support optimal reimbursement. The Nurse Auditor 2 work assignments are varied...in their own time zone. **Required Qualifications** + Active Registered Nurse (RN) license + Minimum of… 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 ... reports findings. + Serves as a clinical resource for coding / denial management and customer service issues. +...AND/OR CERTIFICATIONS + Current Virginia state license as a Registered Nurse or Registered … more
- UPMC (Pittsburgh, PA)
- …Administrator (RHIA) + Registered Health Information Technician (RHIT) + OR Licensed Professional Nurse (LPN) + Registered Nurse (RN) Required: + Act 34 ... **Join UPMC Corporate Compliance as an Intermediate Compliance Auditor !** Are you passionate about ensuring accuracy and compliance in healthcare documentation and… more
- UPMC (Pittsburgh, PA)
- …Administrator (RHIA) + Registered Health Information Technician (RHIT) + Licensed Professional Nurse (LPN) or + Registered Nurse (RN) + Act 34 ... **Join UPMC Corporate Finance as a Compliance Auditor , Associate!** Are you detail-oriented and passionate about...role is crucial in maintaining the integrity of our coding and billing processes, ensuring they meet state and… more
- Elevance Health (Las Vegas, NV)
- …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...+ Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines, and objectivity in the performance… more
- Insight Global (South Jordan, UT)
- …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%...NURSE : Degree in RHIM, RHIA, RHIT with medical coding degree or just CCS is fine with strong… more
- Humana (Corpus Christi, TX)
- …management as needed. Requires applicable State licensure in field of study: Registered Nurse (RN), Licensed Masters Clinical Social Worker (LCSW), Licensed ... accuracy, and Medicare Conditions of Participation demand meticulous documentation. A QA Auditor will help ensure all records meet federal, state, and payer-specific… more
- Robert Half Accountemps (Boston, MA)
- …locally as needed + Strong analytical, organizational, and communication skills + RN ( Registered Nurse ) + Experience working in a Program Integrity role or ... Description Job Title: Medical Claims Auditor - RN Auditor Location: Massachusetts...Experience with MMQ/MDS assessments + Background in claims and coding audits + Strong presentation and stakeholder communication skills… 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. . ... Administrative Law Judge (ALJ) hearings and/or formal meetings with auditor or payor representatives in defense of coding... auditor or payor representatives in defense of coding appeals, as needed. + Maintain necessary audit/appeal activity… more
- Corewell Health (Grand Rapids, MI)
- …relevant experience: + Legal or regulatory field; health care focus desirable + Compliance auditor , nurse auditor , or other audit function + Project ... of services billed, including medical necessity, and compliance with other documentation, coding and billing standards. + Creates clear and accurate audit findings… more
- NCH (Naples, FL)
- …* Minimum of Associate Degree required; Bachelor's Degree preferred. * Licensed as a Registered Nurse in the state of Florida. * 5+ years CDI auditing/SLR ... potential missed opportunities for documentation clarification, act as a liaison between coding and CDI to resolve DRG or other code discrepancies, collaborate with… more