- UPMC (Pittsburgh, PA)
- …modification to company policies and procedures. + Perform audit peer reviews for Clinical Auditor /Analysts. + Provide new-hire training to Clinical ... UPMC Health Plan has an exciting opportunity for a Clinical Auditor /Analyst Intermediate! The Clinical ... care, documentation, and health plan business rules. + Provide a clinical opinion for special projects… more
- Bloom Healthcare (Lakewood, CO)
- RN Clinical Auditor - Location: Mostly Remote (Work from Home) Occasional in-office, field, or education support as directed About Bloom: Bloom Healthcare is a ... chronic conditions. Bloom's model of care is proven to provide exceptional care to the homebound population, and Bloom...delivering high-quality, compliant, and patient-centered end-of-life care. The RN Clinical Auditor plays a vital role in… more
- Baylor Scott & White Health (Dallas, TX)
- …vary based 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 ... and provide counsel to Revenue Integrity team members and/or clinical departments/functions. + Documents and tracks audit findings for account corrections and… more
- Mount Sinai Health System (New York, NY)
- **Job Description** ** Clinical Revenue Auditor -CDM Patient Financial Services-Corporate-Full-Time-Days- Hybrid.** The Clinical Revenue Auditor for the ... financial health and compliance of the organization and bridges the gap between clinical care and medical billing and reimbursement. This position will report to the… more
- Elevance Health (Chicago, IL)
- **Diagnosis Related Group Clinical Validation Auditor -RN (CDI, MS-DRG, AP-DRG and APR-DRG)** **Virtual:** This role enables associates to work virtually ... accommodation is granted as required by law. The **Diagnosis Related Group Clinical Validation Auditor -RN** is responsible for auditing inpatient medical records… more
- St Croix Hospice (Mendota Heights, MN)
- …an extraordinary team of caregivers, then come work where you matter. Compliance Auditor ( Clinical ) Position Overview The Compliance Auditor is responsible ... and working cross-functionally to implement corrective actions. The Compliance Auditor will lead risk assessments, internal audits and compliance investigations… more
- UNC Health Care (Chapel Hill, NC)
- …from entity to entity across the state to train and shadow round with Clinical Documentation Specialists. The CDS auditor provides elbow to elbow support during ... we serve. Summary: This positon trains and audits Inpatient and Outpatient Clinical Documentation Specialists (CDS) across all HCS entities that are owned or… more
- Cleveland Clinic (Cleveland, OH)
- …the Cleveland Clinic team, where you will work alongside passionate caregivers and provide patient-first healthcare. Cleveland Clinic is recognized as one of the top ... healthcare organizations in the world. As a Senior Internal Auditor , you will conduct audit procedures for assigned audits,...Clinic, its subsidiaries, and affiliates. This role leverages both clinical expertise and auditing skills to ensure that … more
- Centene Corporation (Atlanta, GA)
- … documentation, and modify business processes to measure member outcomes. Assess provider performance and quality of care through clinical case reviews. ... + Lead clinical audits for provider medical records both remotely via electronic medical records...quality services + Lead case reviews to assess the clinical performance provided in the provider network,… more
- Insight Global (Plano, TX)
- …years working in an acute care setting or a third-party vendor as a DRG Auditor or Clinical Documentation Specialist (CDS). -CCS Certification RN or BSN RHIT or ... DRG Auditors to join a remote healthcare organization. The DRG Revenue Integrity Auditor will perform Diagnostic Related Group (DRG) validation and quality audits on… more
- Humana (Columbus, OH)
- …our caring community and help us put health first** The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and ... codes (eg, ICD-10-CM, CPT) to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis… more
- Aveanna Healthcare (Homestead, FL)
- …with Investigators, multi-disciplinary research team and Client Company representatives (eg, Clinical Research Associate (CRA), auditor ) Provide support ... Clinical Research Nurse - Illingworth (RN) ApplyRefer a...Nursing Salary: $50.00 - $55.00 per hour Position Details CLINICAL RESEARCH NURSE - Illingworth (RN) Job Overview: Aveanna… more
- Elevance Health (Atlanta, GA)
- **Nurse Auditor Senior - Payment Integrity Complex and Clinical Audit** **Location:** This role enables associates to work virtually full-time, with the ... providers through prepayment claims review, post payment auditing, and provider record review. **How you will make an impact:**...AS in nursing and minimum of 4 years of clinical nursing experience; or any combination of education and… more
- Humana (Columbus, OH)
- …our caring community and help us put health first** The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct ... are met (eg, ICD-10-CM, CPT, HCPCS). The Medical Coding Auditor 's work assignments are varied and frequently require interpretation...to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by… more
- Adecco US, Inc. (Bradenton, FL)
- …education and training to healthcare providers. **Responsibilities of the Coding Auditor and Educator:** . Facilitates optimal clinical documentation performance ... Healthcare & Life Sciences is looking for a **Coding Auditor and Educator** for our client in **Bradenton, FL!**...charts in the EHR and identifies potential gaps in provider documentation . Applies clinical knowledge and… more
- St. Luke's University Health Network (Allentown, PA)
- …or coding determination made by the government or commercial payors, or their auditor representative. + Facilitate clinical chart reviews to assist with ... regardless of a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and… more
- Eurofins US Network (Des Moines, IA)
- …discovery pharmacology, forensics, advanced material sciences and in the support of clinical studies, as well as having an emerging global presence in Contract ... also has a rapidly developing presence in highly specialised and molecular clinical diagnostic testing and in-vitro diagnostic products. In over 30 years, Eurofins… more
- TEKsystems (Annapolis, MD)
- Description JOB SUMMARY The Coding Auditor 1 is proficient in various types of coding and is responsible for performing coding quality audits and providing feedback ... to coders. The Coding Auditor 1 utilizes the International Classification of Disease (ICD-10-CM/PCS),...coding and abstracting system. * Works collaboratively with the Clinical Documentation Specialists and Coaches to communicate opportunities for… more
- Rush University Medical Center (Chicago, IL)
- …each case. **Summary:** As a key role in the Revenue Integrity team, the Auditor & Educator is responsible for conducting reviews of EMR documentation of patient ... accuracy and documentation adequacy. The professional will work collaboratively with clinical providers to improve revenue cycle integrity while seeking and… more
- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- **42910BR** **Extended Job Title:** Medical Coding Auditor **Org Level 1:** Texas Tech Unv Hlth Sci Ctr El Paso **Position Description:** Responsible for auditing ... compliance with healthcare laws and organizational policies. The Medical Coding Auditor collaborates with practice, providers, and other departmental leaders to … more
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