- 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
- SKLD (Bloomfield Hills, MI)
- …responsibilities. Requirements Education, Training, and Experience: *Current State License as a Registered Nurse *CPR Certified *Knowledge and training in all ... and meet Medical necessity per Medicare guidelines. Review Medicaid LOCD compliance during UR meeting and discuss with IDT any residents (including non-skilled… 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...assignment can be substantiated by the documentation in the Medical Record. Job Responsibility + Audits and reviews Medicare/non-Medicare… more
- 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 ... **Req Number** 162995 Job Description Seeking RN - BSN or MSN candidates with a...assignment can be substantiated by the documentation in the Medical Record. Job Responsibility 1.Leverages clinical expertise to identify… more
- Elara Caring (Fort Worth, TX)
- …Time, in the Right Place. **Job Description:** **REMOTE POSITION** The Billing Compliance Auditor performs comprehensive audits within the Skilled Home Health, ... billing, coding, and clinical documentation. Duties of the Billing Compliance Auditor include but are not limited...in Nursing + 5 years of experience as a Registered Nurse in Home Health and/or Hospice… more
- Baylor Scott & White Health (Dallas, TX)
- …on position type and/or level **Job Summary** In this job, as a Clinical Auditor RN , you'll perform charge capture accuracy audits by reviewing and analyzing ... tasks in clinical departments/functions. + Evaluate clinical documentation for compliance , meeting all regulations stipulated by federal and state...least (2) two years of relevant work experience. + Registered Nurse License. As a health care… more
- Community Health Systems (Huntsville, AL)
- **Job Summary** The Registered Nurse ( RN ) provides patient-centered care through the nursing process of assessment, diagnosis, planning, implementation, and ... based on patient assessments and needs. + Responds to medical emergencies and participates in life-saving interventions, such as...control, and quality improvement initiatives. **Licenses and Certifications** + RN - Registered Nurse -… 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
- 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... (CPMA) + Certified Professional Coder (CPC) + Certified Medical Coder (CMC) + Registered Health Information… more
- UPMC (Wexford, PA)
- …Health Information Technician (RHIT) + Licensed Professional Nurse (LPN) + Registered Nurse ( RN ) **UPMC is an Equal Opportunity ... selves? UPMC Children's Community Pediatrics is hiring a Full-Time Compliance Auditor , Intermediate to support the office... (CPMA) + Certified Professional Coder (CPC) + Certified Medical Coder (CMC) + Registered Health Information… more
- PeaceHealth (Vancouver, WA)
- …Public Accountant or Certified Internal Auditor orCertified Information Systems Auditor . + Registered Health Information Administrator (for Coding Auditor ... ), Registered Health Information Technician (for Coding Auditor ), Certified Professional Coder (for Coding Auditor ), Certified Coding Specialist Physician… 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
- ManpowerGroup (St. Paul, MN)
- …convert to FTE **What's the Job?** + Participate in auditing tasks of medical record coding, documentation, compliance , and DRG assignment. + Demonstrate ... Our client, a leader in healthcare innovations, is seeking an Inpatient Auditor to join their team. As an Inpatient Auditor , you will be part of the Consulting… more
- Nuvance Health (Danbury, CT)
- *Description* *Summary:* The Charge Integrity Auditor performs detailed chart to bill audits of inpatient or outpatient medical accounts, comparing the ... practices across the Nuvance Health System. The Charge Integrity Auditor coordinates and reports audits savings or losses for...reports audits savings or losses for the facilities and medical groups, data processing errors, the performance of the… more
- ProMedica Health System (Toledo, OH)
- REPORTING RELATIONSHIPS Reports to the Director of Compliance Shared Services within the Compliance Department. POSITION SUMMARY Utilize compliance expertise ... to assist in the performance of compliance audits and support regulatory compliance functions at all entities across the system as a service to the Board of… more
- Centene Corporation (Salem, OR)
- …for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering ... + Train internal audit participants/business owners on audit tools and Medical Management criteria including CM, DM, and UM **Education/Experience:** Bachelor's… more
- AdventHealth (Altamonte Springs, FL)
- …**LICENSURE, CERTIFICATION OR REGISTRATION REQUIRED:** . Current active State license as a Registered Nurse , Nurse Practitioner, or Physician's Assistant . ... to provide feedback to CDI Market Leaders + Performs quality reviews of the medical record for compliance including completeness and accuracy for severity of… more
- Houston Methodist (Houston, TX)
- …in nursing or other healthcare related field; may consider HM employee with Registered Nurse license and four additional years of directly related experience ... programs; works across the system to assess, measure, and report compliance with standards; and develops, implements and evaluates strategies to promote… more
- University of Texas Rio Grande Valley (Harlingen, TX)
- …RN ) will be required after 6 months of employment. Preferred: Certified Professional Medical Auditor ( CPMA ) from American Academy Professional Coders ( AAPC ... rendered to patients. * Conducts complex reviews of physician/provider billing compliance activities in accordance with applicable laws, regulations, rules or… more
- Commonwealth Care Alliance (Boston, MA)
- …Professional Coder (CPC) + Certified Inpatient Coder (CIC) + Certified Professional Medical Auditor (CPMA) **Desired Education (nice to have):** + Masters ... direction of the Sr. Director, TPA Management and Claims Compliance , Healthcare Medical Claims Coding Sr. Analyst...applicable)), an OIG Report and verification of a valid MA/ RN license (if applicable). Commonwealth Care Alliance is an… more
