- Northwell Health (Garden City, NY)
- …information leading to the assignment can be substantiated by the documentation in the Medical Record. Seeking RN candidates with a HCS-D - Home Care Coding ... charts to ensure that proper standards are maintained in compliance with Federal and State regulations. 5.Applies coding rules...and related experience. 2.Current License to practice as a Registered Professional Nurse in New York State… 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... (CPMA) + Certified Professional Coder (CPC) + Certified Medical Coder (CMC) + OR 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 ... months contract with potential extends or Convert** **Job Description:** + The HEDIS Nurse Auditor is responsible for conducting quality audits related to state… more
- Robert Half Accountemps (Boston, MA)
- Description Job Title: Medical Claims Auditor - RN Auditor Location: Massachusetts - 90% Remote Job Type: 1 Year Contract - Potential for Perm Hire ... 1, 2025 Job Description We are seeking a qualified Auditor with healthcare experience to support Program Integrity activities...needed + Strong analytical, organizational, and communication skills + RN ( Registered Nurse ) + Experience… more
- Providence (WA)
- **Description** The Revenue Cycle Auditor is responsible for providing patient focused, standardized, compliant revenue cycle support that will assist Providence St ... financial objectives. - Conduct audits (individual chart/bill audits, focus audits, compliance audits, payer defense audits, patient requests for audit and post… more
- Guthrie (Sayre, PA)
- Option to be Hybrid/Remote. Summary: A senior level compliance coding auditor conducting assessments in accordance with The Guthrie Clinic's policies and ... procedures and accepted guidelines for medical coding. Works closely with the Compliance ...(RHIA, RHIT, or CCS) or AAPC (CPC) required + RN /LPN or CPMA preferred + Required to sit for… more
- Mount Sinai Health System (New York, NY)
- …Technologist and related professions). + Certifications such as Certified Professional Medical Auditor (CPMA), Certified Inpatient Coder (CIC), Certified Coding ... **Job Description** **Clinical Revenue Auditor -CDM Patient Financial Services-Corporate-Full-Time-Days- Hybrid.** The Clinical Revenue...a key role in ensuring the financial health and compliance of the organization and bridges the gap between… 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 ... medical necessity or appropriateness of services. + Conducts compliance , defense, LifeNet and special focus audits and reports...AND/OR CERTIFICATIONS + Current Virginia state license as a Registered Nurse or Registered … 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
- 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 ... discharge disposition, and any other relevant data to ensure coding accuracy. The auditor is also responsible for writing and defending appeal letters to payers with… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Revenue Integrity Auditor Full Time, 80 Hours Per Pay Period, Day Shift Covenant Health Overview: Covenant Health is the region's top-performing healthcare ... , outpatient and specialty services (http://www.covenanthealth.com/services/) , and Covenant Medical Group (http://www.covenantmedicalgroup.org/) , our area's fastest-growing physician practice… more
- University of Washington (Seattle, WA)
- …**Desired Qualifications** . Master's Degree in business, accounting or related discipline . Medical coding knowledge or experience . RN or equivalent provider ... intellectual excitement, artistic pursuits, and natural beauty. The senior healthcare auditor is responsible for the completion of internal audits within the… more
- Humana (Corpus Christi, TX)
- …and quality committees. + Support continuous quality improvement initiatives to enhance compliance and patient safety. **Qualifications** + Active RN license ... community and help us put health first** The Home Health Quality Auditor ensures clinical documentation meets CMS regulations, OASIS accuracy, and Medicare… more
- Centene Corporation (Jefferson City, MO)
- …Social Worker (LCSW), Licensed Mental Health Counselor (LMHC), Licensed Professional Counselor (LPC), Registered Nurse ( RN ), or Licensed Practical Nurse ... the use of audit process and tools + Facilitate compliance with the auditing process + Act as a...IN MISSOURI **Ideal candidate will be a Licensed Practical Nurse (LPN) with auditing experience.** **Education/Experience:** Bachelor's degree in… more
- Insight Global (Plano, TX)
- …working in an acute care setting or a third-party vendor as a DRG Auditor or Clinical Documentation Specialist (CDS). -CCS Certification RN or BSN RHIT or RHIA ... DRG Auditors to join a remote healthcare organization. The DRG Revenue Integrity Auditor will perform Diagnostic Related Group (DRG) validation and quality audits on… more
- Banner Health (AZ)
- …using statistically reliable sampling methods. 2. Coordinates, retrieves, and performs medical record audits to determine provider compliance with established ... including remote and hybrid opportunities. As a **Licensed Practical Nurse (LPN)** for **Banner Health Plans** , you will...will be an integral part of the **Health Plan Medical Management Team** . This assignment-based role focuses on… 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. . ... care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and coding of all diagnosis and procedure codes to… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …investigating and remediating allegations of FWA while adhering to compliance and regulatory requirements. Primary activities include substantiating referrals, case ... planning and research, conducting onsite or desk audits, clinical reviews of medical records to ensure correct billing of services and appropriateness of care,… more
- LA Care Health Plan (Los Angeles, CA)
- …Fraud Examiner (CFE) Certified HealthCare Compliance (CHC) Certified Internal Auditor (CIA) Certified Coder, RN , MD, PharmaD, or equivalent Required ... Director, Compliance on Special Investigations Unit and Fraud, Waste...Off (PTO) + Tuition Reimbursement + Retirement Plans + Medical , Dental and Vision + Wellness Program + Volunteer… more
- University of Southern California (Alhambra, CA)
- …principles. + Pref Skills and knowledge on the following software: Cerner and Craneware + Pref Registered Nurse - RN (CA Board of Registered Nursing) + ... . The Senior RI Specialist also coordinates with Keck Medical Center of USC Administration, IS, Compliance ,...and provides leadership by providing direction to the revenue auditor team to all entities of Keck Medical… more