• Compliance Auditor , Intermediate…

    UPMC (Pittsburgh, PA)
    Registered Health Information Technician (RHIT) + OR Licensed Professional Nurse (LPN) + Registered Nurse ( RN ) Required: + Act 34 **UPMC is an Equal ... Auditor !** Are you passionate about ensuring accuracy and compliance in healthcare documentation and billing ? Do...Registered Health Information Administrator (RHIA) + … more
    UPMC (10/10/25)
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  • Compliance Auditor , Associate

    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...+ 1 year of experience in medical coding, auditing, billing and compliance . + Knowledge of CMS… more
    UPMC (10/23/25)
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  • Home Health Quality Assurance Auditor

    Humana (Corpus Christi, TX)
    …process management as needed. Requires applicable State licensure in field of study: Registered Nurse ( RN ), Licensed Masters Clinical Social Worker (LCSW), ... 1 consults and collaborates with clinicians to ensure high accountability of compliance and quality. The Quality Assurance, Clinical Professional 1 work assignments… more
    Humana (10/01/25)
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  • Clinical Revenue Auditor -CDM Patient…

    Mount Sinai Health System (New York, NY)
    …risk of compliance violations, audits, and potential penalties related to billing errors. + Streamline charge capture processes to improve efficiency and reduce ... **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
    Mount Sinai Health System (09/24/25)
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  • Compliance Coding Auditor

    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 ... requirements. + Minimum 1-year experience in Physician coding and billing and/or compliance field required 5 year...(RHIA, RHIT, or CCS) or AAPC (CPC) required + RN /LPN or CPMA preferred + Required to sit for… more
    Guthrie (09/13/25)
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  • Revenue Integrity Nurse Auditor

    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 ... + Serves as a resource to hospital departments regarding compliance with billing regulations and trends in...AND/OR CERTIFICATIONS + Current Virginia state license as a Registered Nurse or Registered more
    Childrens Hospital of The King's Daughters (10/23/25)
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  • Medical Investigator I/II ( RN Required)

    Excellus BlueCross BlueShield (Rochester, NY)
    …investigating and remediating allegations of FWA while adhering to compliance and regulatory requirements. Primary activities include substantiating referrals, case ... or desk audits, clinical reviews of medical records to ensure correct billing of services and appropriateness of care, interviewing potential witnesses, developing… more
    Excellus BlueCross BlueShield (09/17/25)
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  • Medicare/Medicaid Claims Editing Specialist

    Commonwealth Care Alliance (Boston, MA)
    …under the direction of the Sr. Director, TPA Management and Claims Compliance , Healthcare Medical Claims Coding Sr. Analyst will be responsible for developing ... claims data sets to provide analysis and reports on existing provider billing patterns as compared to industry standard coding regulations, and make recommendations… more
    Commonwealth Care Alliance (08/26/25)
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