• Clinical Auditor /Analyst…

    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
    UPMC (01/06/26)
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  • RN Clinical Auditor

    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
    Bloom Healthcare (01/10/26)
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  • Clinical Auditor RN - Hybrid

    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
    Baylor Scott & White Health (12/25/25)
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  • Clinical Revenue Auditor -CDM…

    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
    Mount Sinai Health System (12/24/25)
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  • Diagnosis Related Group Clinical Validation…

    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
    Elevance Health (01/07/26)
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  • Compliance Auditor ( Clinical )

    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
    St Croix Hospice (12/30/25)
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  • Clinical Documentation Specialist…

    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
    UNC Health Care (12/31/25)
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  • Senior Internal Auditor ( Clinical )

    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
    Cleveland Clinic (01/10/26)
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  • Quality Improvement Auditor

    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
    Centene Corporation (01/06/26)
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  • DRG Revenue Integrity Auditor

    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
    Insight Global (10/30/25)
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  • Inpatient Medical Coding Auditor

    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
    Humana (12/23/25)
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  • Clinical Research Nurse - Illingworth (RN)

    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
    Aveanna Healthcare (01/06/26)
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  • Nurse Auditor Senior - Payment Integrity…

    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
    Elevance Health (12/24/25)
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  • Medical Coding Auditor

    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
    Humana (01/07/26)
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  • Coding Auditor and Educator

    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
    Adecco US, Inc. (12/30/25)
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  • RN Clinical Review Appeals Specialist…

    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
    St. Luke's University Health Network (10/28/25)
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  • Lead Auditor

    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
    Eurofins US Network (12/30/25)
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  • Inpatient Coding Auditor

    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
    TEKsystems (01/05/26)
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  • Coding Auditor and Educator

    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
    Rush University Medical Center (01/09/26)
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  • Medical Coding Auditor

    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
    Texas Tech University Health Sciences Center - El Paso (12/29/25)
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