- Yale New Haven Health (Fairfield, CT)
- …notice when transitioning or resigning from the call team. Responsibilities 1. Clinical Care 1.1 The Certified Registered Nurse Anesthetist (CRNA) implements ... patient at the center of everything we do, we focus on improving clinical care, outcomes, patient satisfaction, safety, value, clinical research, and education.… more
- UNC Health (Chapel Hill, NC)
- …from entity to entity across the state to train and shadow round with Clinical Documentation Specialists. The CDS auditor provides elbow to elbow support during ... we serve. Summary: This positon trains and audits Inpatient and Outpatient Clinical Documentation Specialists (CDS) across all HCS entities that are owned or… more
- Providence (WA)
- …for conducting clinical quality audits for the Quality Department. The auditor identifies and coordinates clinical audits to determine potential areas for ... regarding charts require auditing will be provided by staff Clinical QI Coordinator RNs. The auditor maintains...**Required Qualifications:** + Degree in Nursing + Oregon Registered Nurse License + 5+ years clinical experience… more
- MD Anderson Cancer Center (Houston, TX)
- As a * Nurse Defense Auditor * in our *Hospital Billing & Collections* department, your expertise ensures accurate reimbursement and supports patient access to ... substitute preferred degree for two years of the five clinical nursing experience. * Preferred: Nurse Defense...the five clinical nursing experience. * Preferred: Nurse Defense Audit experience, experience with insurance appeals, prior… 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...CERTIFICATIONS + Current Virginia state license as a Registered Nurse or Registered Nurse holding a valid… more
- Elevance Health (Washington, DC)
- **Diagnosis Related Group Clinical Validation Auditor -RN (CDI, MS-DRG, AP-DRG and APR-DRG)** **Virtual:** This role enables associates to work virtually ... an accommodation is granted as required by law. The **Diagnosis Related Group Clinical Validation Auditor ** is responsible for auditing inpatient medical records… more
- Banner Health (AZ)
- …employment settings by including remote and hybrid opportunities. As a **Licensed Practical Nurse (LPN)** for **Banner Health Plans** , you will be an integral part ... . This assignment-based role focuses on independent chart review and clinical assessment. **Key Responsibilities** : + Independently review patient medical charts… more
- Northwell Health (Westbury, NY)
- …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 ... + Instructs professional staff in code changes, as needed. + Assists clinical staff and nursing supervisors in providing appropriate documentation in the Medical… more
- Northwell Health (Garden City, NY)
- …HCS-D - Home Care Coding Specialist-Diagnosis, COS-C Certificate for OASIS Specialist- Clinical . Remote position Job Responsibility 1.Leverages clinical expertise ... and related experience. 2.Current License to practice as a Registered Professional Nurse in New York State required, plus specialized certifications as needed.… more
- AdventHealth (Orlando, FL)
- …Full Time **Shift** : Days **Location: Remote** **The role you'll contribute:** The Clinical Documentation Integrity Manager is a Registered Nurse and/or a ... Registered Health Information Administrator with a high level of clinical proficiency necessary for the oversight of the Clinical Documentation team which is… more
- Providence (MT)
- …people, we must empower them._** **Providence Health Plan is calling a Coding Quality Auditor , HEDIS who will:** + Be responsible for conducting clinical quality ... for the Quality Department + Identify and reports issues related to clinical audits to determine potential areas for quality improvement within the HEDIS… more
- Insight Global (South Jordan, UT)
- …criteria, and coding terminology. Expert coding knowledge (DRG & ICD-10) Registered Nurse RN (must be inpatient) WITH coding/ clinical documentation certification ... Job Description Insight Global is seeking a DRG Validation Auditor for one of our clients to sit 100%...in clinical documentation) OR IF NOT A NURSE : Degree in RHIM, RHIA, RHIT with medical coding… more
- AdventHealth (Orlando, FL)
- …The Surgical and Procedural Services Safety and Regulatory Compliance Auditor evaluates the surgical and procedural environment, policies, and procedures ... and regulations. Responsible for performing routine readiness rounding in clinical areas to identify areas of opportunity and prepare...Florida or multi state license as a Licensed Practical Nurse **or** + RN current valid State of Florida… more
- CVS Health (Phoenix, AZ)
- …heart, each and every day. **Position Summary** The **Healthcare Quality Management Auditor ** participates in the development and ongoing implementation of QM ( ... to)** + Completes a variety of onsite medical and clinical audits for all lines of business, including AHCCCS...in QM meetings. **Required Qualifications** + Active RN (Registered Nurse ) or LPN (Licensed Practical Nurse ) license,… more
- US Tech Solutions (Newark, NJ)
- …months contract with potential extends or Convert** **Job Description:** + The HEDIS Nurse Auditor is responsible for conducting quality audits related to state ... to identify trends and facilitate quality improvement initiatives. + Assist with clinical studies, quality projects, and audits. + Lead and coordinate Corrective… more
- Centene Corporation (Jefferson City, MO)
- …the auditing of corporate, health plan, and specialty company staff related to clinical systems entry and/or processes + Develop and maintain the audit process and ... audit errors + Coordinate auditing outcomes and system maintenance with the Sr. + Clinical Systems Specialist to resolve or enhance clinical systems + Performs… more
- SSM Health (MO)
- …Summary:** Performs as a vital member of the interdisciplinary care team member, an auditor , and an educator ensuring medical records are complete and clinical ... and electronic health record charts that accurately capture the clinical picture. **Job Responsibilities and Requirements:** PRIMARY RESPONSIBILITIES + Reviews… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …drivers. Essential Accountabilities Level I + Handles physical health member clinical management programs. + Maintains knowledge of current Case Management Society ... or external referral sources. Applies case management criteria and professional clinical judgment to determine a member's appropriateness for case management… more
- St. Luke's University Health Network (Allentown, PA)
- …or coding determination made by the government or commercial payors, or their auditor representative. + Facilitate clinical chart reviews to assist with ... regardless of a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and… more
- University of Southern California (Alhambra, CA)
- As the center of clinical charge capture, the Revenue Integrity (RI) Specialist provides leadership to the daily CDM maintenance workflow between the various ... coordinates with Keck Medical Center of USC Administration, IS, Compliance, Clinical Informatics and Integration personnel on technology projects impacting charge… more
