- Optum (San Juan, PR)
- …as provide development for other roles you may be interested in. Required Qualifications: Registered Nurse ( RN ), Coding Certificate or Nursing Licensure, for ... and pursue recoveries Ensure adherence to state and federal compliance policies, reimbursement policies, and contract compliance ...example: Puerto Rico Registered Nurse Certified Professional Coder (CPC) +… more
- Zenith (Sarasota, FL)
- …state fee schedules, coding guidelines, healthcare regulations and medical compliance . Monitors billing for trends. Communicates with providers regarding disputed ... Legal department on fee schedule guidelines, billing rules and medical compliance /standards. Consults Legal on bill reimbursement and state appeals. Evaluates and… more
- Ochsner LSU Health System (Shreveport, LA)
- …of related healthcare experience with a master's degree. Certifications Required - Current registered nurse ( RN ) license in state of practice. Preferred ... projects and conducts internal training to ensure competency and compliance in all aspects of the revenue cycle. To...apply to the assigned area of responsibility and ensures compliance with all such laws, regulations and standards. This… more
- Texas Health and Human Services Commission (Denton, TX)
- …health and safety of staff and individuals. Works under the limited supervision of a Registered Nurse ( RN ), with considerable latitude for the use of ... as a Licensed Vocational Nurse (LVN) or Registered Nurse ( RN ) in the...Auditor 's Office - Job Descriptions. ADA Accommodations: In compliance with the Americans with Disabilities Act (ADA), HHSC… 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 ... care and meet Medical necessity per Medicare guidelines. Review Medicaid LOCD compliance during UR meeting and discuss with IDT any residents (including non-skilled… 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...Registered Health Information Administrator (RHIA) + … 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
- 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 and passionate about ensuring compliance in healthcare? **UPMC… more
- UPMC (Wexford, PA)
- …Health Information Technician (RHIT) + Licensed Professional Nurse (LPN) + Registered Nurse ( RN ) **UPMC is an Equal Opportunity ... be their best selves? UPMC Children's Community Pediatrics is hiring a Full-Time Compliance Auditor , Intermediate to support the office Remotely. Must live in… 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)
- …clinical field or equivalent experience. 4+ years of combined clinical and compliance or auditing experience in a healthcare environment. Familiarity with Health ... managed care practices and policies preferred. **Licensure/Certifications:** Current state RN license required. Valid driver's license.Pay Range: $68,700.00 -… 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...charts to ensure that proper standards are maintained in compliance with Federal and State regulations. 5.Applies coding rules… 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...charts to ensure that proper standards are maintained in compliance with Federal and State regulations. + Applies coding… more
- Molina Healthcare (Fort Worth, TX)
- …Nursing License ( RN may be preferred for specific roles) + Certified HEDIS Compliance Auditor (CHCA) To all current Molina employees: If you are interested ... in applying for this position, please apply through the intranet job listing Molina Healthcare offers a competitive benefits and compensation package Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $54,922 - $107,099 / ANNUAL… 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 ... and staff. + Participates in audits, chart reviews, and compliance checks to ensure adherence to standards of practice...control, and quality improvement initiatives. **Licenses and Certifications** + RN - Registered Nurse -… more
- Molina Healthcare (Las Vegas, NV)
- …Nursing License ( RN may be preferred for specific roles) + Certified HEDIS Compliance Auditor (CHCA) To all current Molina employees: If you are interested ... Program Management and Performance oversees and leads activities to maintain compliance with state requirements and federal and/or NCQA quality requirements, as… more
- MyFlorida (Alachua, FL)
- REGISTERED NURSE SPECIALIST - 64082415 Date: Jul 24, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... . Requisition No: 852184 Agency: Department of Health Working Title: REGISTERED NURSE SPECIALIST - 64082415 Pay Plan: Career Service… 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 ... timely manner. + Prepares trend and other reports for compliance audits and charge processes. + Serves as a...AND/OR CERTIFICATIONS + Current Virginia state license as a Registered Nurse or Registered … more
