- UNC Health (Chapel Hill, NC)
- …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 ... all patients. Educates on proper creation of provider compliant queries. 8. Ensures compliance with third party and State and Federal regulations. 9. Audits CDS… more
- UPMC (Pittsburgh, PA)
- **Join UPMC Corporate Compliance as an Intermediate Compliance Auditor !** Are you passionate about ensuring accuracy and compliance in healthcare ... **UPMC Corporate Compliance ** is seeking a dedicated and detail-oriented **Intermediate Compliance Auditor ** to join our team! This position will be based… 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...CERTIFICATIONS + Current Virginia state license as a Registered Nurse or Registered Nurse holding a valid… more
- Northwell Health (Glen Cove, NY)
- …Medicare/non-Medicare charts to ensure that proper standards are maintained in compliance with Federal and State regulations. 5.Applies coding rules and regulations ... the validation review process. 6.Reviews codes on Medicare/non-Medicare charts for compliance to rules and conventions. 7.Communicates DRG changes and rationale to… 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 ... Coordinates, retrieves, and performs medical record audits to determine provider compliance with established AHCCCS standards for documentation in conjunction with… more
- Northwell Health (Westbury, NY)
- …reviews Medicare/non-Medicare charts to ensure that proper standards are maintained in compliance with Federal and State regulations. + Applies coding rules and ... the validation review process. + Reviews codes on Medicare/non-Medicare charts for compliance to rules and conventions. + Instructs professional staff in code… 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 Hours: 40 ... Start Date: December 1, 2025 Job Description We are seeking a qualified Auditor with healthcare experience to support Program Integrity activities for a state… more
- AdventHealth (Orlando, FL)
- …you'll contribute:** The Surgical and Procedural Services Safety and Regulatory Compliance Auditor evaluates the surgical and procedural environment, policies, ... and procedures to ensure compliance with all regulatory standards and regulations. Responsible for...Florida or multi state license as a Licensed Practical Nurse **or** + RN current valid State of Florida… 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 ... Conduct on-site reviews at provider offices to assess record quality and compliance with documentation standards. + Prepare reports summarizing findings and provide… 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 level ... team:** + Reviews concurrent and retrospective medical record for documentation compliance including completeness and accuracy for severity of illness (SOI), risk… more
- Centene Corporation (Jefferson City, MO)
- …staff at the health plan in the use of audit process and tools + Facilitate compliance with the auditing process + Act as a consultant related to system auditing to ... RESIDE IN MISSOURI **Ideal candidate will be a Licensed Practical Nurse (LPN) with auditing experience.** **Education/Experience:** Bachelor's degree in related… more
- Clark County, NV (Las Vegas, NV)
- GUARDIANSHIP COMPLIANCE INVESTIGATOR I/II Print (https://www.governmentjobs.com/careers/clarkcounty/jobs/newprint/5151944) Apply GUARDIANSHIP COMPLIANCE ... is seeking qualified candidates to apply for the Guardianship Compliance Investigator I/II position. This position performs complex document...retail or mail order fills) + 24/7 Telephone Advice Nurse - no employee cost + Teledoc, Doctoroo, and… more
- University of Southern California (Alhambra, CA)
- …to evaluate department charge processes to improve charge capture and coding compliance . The Senior RI Specialist also coordinates with Keck Medical Center of ... USC Administration, IS, Compliance , Clinical Informatics and Integration personnel on technology projects...and provides leadership by providing direction to the revenue auditor team to all entities of Keck Medical Center… more
- GE Vernova (Wilmington, NC)
- …resources. + Maintain and develop applications/software solutions for continued compliance and improvements including administration and deployment of software ... willingness to complete qualification and certification as a Lead Auditor . + Availability and willingness for periodic travel to...access to Health Coach from GE Vernova, a 24/7 nurse -based resource; and access to the Employee Assistance Program,… more
- St. Luke's University Health Network (Allentown, PA)
- …coding determination made by the government or commercial payors, or their auditor representative. + Facilitate clinical chart reviews to assist with supporting ... + Participate in Administrative Law Judge (ALJ) hearings and/or formal meetings with auditor or payor representatives in defense of coding appeals, as needed. +… more
- Dignity Health (Rancho Cordova, CA)
- …ensuring all relevant documentation is presented to the Medical Director. The nurse must meticulously track and document all appeal activities, guaranteeing timely ... resolution in compliance with federal, state, and local regulations, including CMS...maintaining a detailed activity log for leadership review. The nurse will actively participate in audits, identifying and implementing… more
- Trinity Health (Livonia, MI)
- …to intra-departmental Revenue Integrity colleagues including areas of opportunity. Assist Nurse Auditor and/or other stakeholders with denial related charge ... coding credentials _and/or Licensed Vocational Nurse / Licensed Practical Nurse licensure_ is required. CHC (Healthcare Compliance Certification) preferred.… more
- GE Vernova (Clearwater, FL)
- **Job Description Summary** To ensure environmental compliance via recordkeeping, reporting with program implementation and management. Additionally, develop and ... Lead you will: + Be responsible for supporting air, waste and water compliance for our Clearwater and other Power Transmission manufacturing sites + Support… more
- GE Vernova (Schenectady, NY)
- …- Rigorously execute the supplier evaluation process, including quality & compliance audits / assessments to ensure that only appropriately qualified suppliers ... + Provide technical guidance to suppliers to assure product/process compliance with engineering drawings and specifications + Work closely...such as from ASTM, ASME etc + ISO Lead auditor certified by 3rd party registrar or accepted internal… more
- GE Aerospace (Chicago, IL)
- …business stakeholders to understand existing cost accounting practices, assess their compliance with the Cost Accounting Standards (CAS), facilitate any required ... changes to ensure compliance with CAS, and having mechanisms in place to...with senior DCMA (ACO, DACO, CACO) and DCAA (supervisory auditor , Branch Manager, Regional Audit Manager). + Strong cost… more
