- Yale New Haven Health (Southport, CT)
- …our organization, every employee should understand and share in the Yale New Haven Health System Vision, support our Mission, and live our Values. These values - ... as individuals and professionals, every day. Why Choose Yale New Haven Health ? Excellent work environment - Flexible schedules to ensure work-life balance. Keeping… 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 ... reimbursement to the health system from third party payers. Reports to the...regulations and trends in denials of services due to medical necessity or appropriateness of services. + Conducts compliance,… more
- Banner Health (AZ)
- …to employment settings by including remote and hybrid opportunities. As a **Licensed Practical Nurse (LPN)** for **Banner Health Plans** , you will be an ... integral part of the ** Health Plan Medical Management Team** . This assignment-based role focuses on independent chart review and clinical assessment. **Key… more
- Northwell Health (Westbury, NY)
- …Coding Specialist-Diagnosis, COS-C Certificate for OASIS Specialist-Clinical. Conducts Home Health Resource Group (HHRG) Validation to ensure the diagnostic ... to the assignment can be substantiated by the documentation in the Medical Record. Job Responsibility + Audits and reviews Medicare/non-Medicare charts to ensure… more
- Northwell Health (Glen Cove, NY)
- …to the assignment can be substantiated by the documentation in the Medical Record. Job Responsibility 1.Leverages clinical expertise to identify and validate DRG ... and related experience. 2.Current License to practice as a Registered Professional Nurse in New York State required, plus specialized certifications as needed. 3.… more
- UPMC (Pittsburgh, PA)
- …Coder (CIC) + Certified Evaluation & Management Coder (CEMC) + Certified Professional Medical Auditor (CPMA) + Certified Professional Coder (CPC) + Certified ... Medical Coder (CMC) + OR Registered Health ...Health Information Technician (RHIT) + OR Licensed Professional Nurse (LPN) + Registered Nurse (RN) Required:… more
- Elevance Health (Washington, DC)
- …is granted as required by law. The **Diagnosis Related Group Clinical Validation Auditor ** is responsible for auditing inpatient medical records to ensure ... **Diagnosis Related Group Clinical Validation Auditor -RN (CDI, MS-DRG, AP-DRG and APR-DRG)** **Virtual:** This...an impact:** + Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines, and objectivity in… more
- Providence (MT)
- …we know that to inspire and retain the best people, we must empower them._** **Providence Health Plan is calling a Coding Quality Auditor , HEDIS who will:** + Be ... + Utah **Required Qualification:** + Technical certification/licensure in the area of Medical Assistant, Certified Nurse Assistant, or Licensed Practical … more
- CVS Health (Phoenix, AZ)
- …Strong relationship building skills. + Previous experience in an outpatient behavioral health environment. + Previous experience working with medical records ... At CVS Health , we're building a world of health...and every day. **Position Summary** The **Healthcare Quality Management Auditor ** participates in the development and ongoing implementation of… more
- UNC Health Care (Chapel Hill, NC)
- …inclusive organization with over 40,000 teammates, whose mission is to improve the health and well-being of the unique communities we serve. Summary: This positon ... 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
- AdventHealth (Orlando, FL)
- …Days Off from Day One Career Development Whole Person Wellbeing Resources Mental Health Resources and Support **Our promise to you:** Joining AdventHealth is about ... hospital, 1,368-bed AdventHealth Orlando + We offer great benefits with immediate Health Insurance coverage + Career growth and advancement potential + Serves as… 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 ... experience, preferably in the healthcare industry. + **Active New Jersey Registered Nurse (RN) License required.** **Skills:** + Knowledge of managed care principles… more
- Centene Corporation (Jefferson City, MO)
- …Mental Health Counselor (LMHC), Licensed Professional Counselor (LPC), Registered Nurse (RN), or Licensed Practical Nurse (LPN) Pay Range: $55,100.00 ... one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national… more
- AdventHealth (Orlando, FL)
- …role you'll contribute:** The Clinical Documentation Integrity Manager is a Registered Nurse and/or a Registered Health Information Administrator with a high ... + Additional Licenses and Certifications Current active State license as a Registered Nurse , Nurse Practitioner, Physicians Assistant, Medical Physician, or… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Work, Behavioral Health , Respiratory Therapy, Registered Dietitian, Registered Nurse , Medical Director, Pharmacist, Geriatrics, etc.) to ensure continuity ... activities in accordance with departmental, corporate, NYS Department of Health (DOH), Centers for Medicaid & Medicare Services (CMS),...NYS DOH, CMS, NCQA, and HEDIS, serving as internal auditor within the group. + Responsible for all aspects… more
- Baystate Health (Springfield, MA)
- …below represent the base salaries for all positions at a given grade across the health system. Typically, a new hire can expect a starting salary somewhere in the ... employees. Minimum - Midpoint - Maximum $16.68 - $20.39 - $25.36 **Baystate Health , a nationally recognized leader in healthcare quality and safety, is looking for… more
- Baystate Health (Springfield, MA)
- …below represent the base salaries for all positions at a given grade across the health system. Typically, a new hire can expect a starting salary somewhere in the ... employees. Minimum - Midpoint - Maximum $16.68 - $20.39 - $25.36 **Baystate Health , a nationally recognized leader in healthcare quality and safety, is looking for… more
- Baystate Health (Springfield, MA)
- …below represent the base salaries for all positions at a given grade across the health system. Typically, a new hire can expect a starting salary somewhere in the ... employees. Minimum - Midpoint - Maximum $16.02 - $18.41 - $21.04 **Baystate Health , a nationally recognized leader in healthcare quality and safety, is looking for… more
- St. Luke's University Health Network (Allentown, PA)
- …as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless ... of a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively...The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and coding of all diagnosis… 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 ... documentation comprehensively represents the current health status of network patients against ever-changing risk adjusted models. Responsible for achieving improved… more
