- UNC HEALTH (Morrisville, NC)
- …and well-being of the unique communities we serve. Summary: The Pharmacy Auditor will work closely with the Department's leadership team and multidisciplinary ... involved in the prevention and reaction to drug diversion. The Pharmacy Auditor is responsible for gathering, interpreting, sharing, and broadly influencing … more
- Mass General Brigham (Somerville, MA)
- …mandates, applicable benefit language, coding requirements, and consideration of relevant clinical information with a focus on overpayment identification. This role ... applicable benefit language, coding requirements and consideration of relevant clinical information with a focus on overpayment identification. Utilize expert… more
- Optum (San Juan, PR)
- …of the claim for further review in a production environment. Primary Responsibilities: Clinical Case Reviews -75% Perform clinical review of professional (or ... and accuracy. Standards are defined by the department Provide clear and concise clinical logic to the providers when necessary Examine, assess, and document business… more
- Regency Integrated Health Services (Austin, TX)
- …TX Position Type Full Time Description We are seeking a detail-oriented and experienced Compliance Auditor and Investigator to join our team. This role is ... responsibility of this position is to audit our long-term care facilities for compliance with the Office of Inspector General's (OIG) compliance program specific… more
- Catalent, Inc. (Kansas City, MO)
- …home to our Oral & Specialty Drug Delivery, Biologics Analytical Services and Clinical Supply Services businesses. The site provides a range of integrated services ... solid dosage forms, from formulation development and analytical testing to clinical and commercial-scale manufacture. The Kansas City facility is a… more
- Texas Health and Human Services Commission (San Antonio, TX)
- …at Texas State Auditor 's Office - Job Descriptions. ADA Accommodations: In compliance with the Americans with Disabilities Act (ADA), HHSC and DSHS agencies will ... state hospital buildings and treatment units; providing housekeeping services in a clinical setting, which also involves conducting inspections of the buildings and… more
- Astrix Technology (Los Angeles, CA)
- ** Clinical Compliance Auditor ** Clinical Los Angeles, CA, US Pay Rate Low: 100000 | Pay Rate High: 150000 + Added - 04/04/2025 Apply for Job We're ... in the biotechnology industry, and they're on the lookout for a talented ** Clinical Compliance Auditor ** to join their dynamic team! If you're passionate… more
- Centene Corporation (Salem, OR)
- …in a clinical field or equivalent experience. 4+ years of combined clinical and compliance or auditing experience in a healthcare environment. Familiarity ... the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified,… more
- Elara Caring (Fort Worth, TX)
- …to eligibility, billing, coding, and clinical documentation. Duties of the Billing Compliance Auditor include but are not limited to: (1) conducting audits ... Time, in the Right Place. **Job Description:** **REMOTE POSITION** The Billing Compliance Auditor performs comprehensive audits within the Skilled Home Health,… more
- Sharp HealthCare (San Diego, CA)
- …for the position, and employer business practices. **What You Will Do** The Compliance Coding Auditor is responsible for the administration of the Sharp ... timeframe. **Essential Functions** + Coding ComplianceCompliance Coding and Billing AuditsThe Compliance Coding Auditor has the primary responsibility of… more
- Elevance Health (Hanover, MD)
- ** Clinical Provider Auditor I** **Supports Payment Integrity & Behavioral Health** _Location:_ This field-based role enables associates to primarily operate in ... insightful analytics to improve the delivery of care. The ** Clinical Provider Auditor I** is responsible for...will you make an impact:** + Examines claims for compliance with relevant billing and processing guidelines and identifies… more
- Elevance Health (Grand Prairie, TX)
- ** Clinical Provider Auditor II** **Supports the Payment Integrity line of business** **Hybrid 1:** This role requires associates to be in-office **1-2** days per ... is determined to recover, eliminate and prevent unnecessary medical-expense spending. The ** Clinical Provider Auditor II** is responsible for identifying issues… 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 executing audit tasks in clinical departments/functions. + Evaluate clinical documentation for compliance , meeting all regulations stipulated by federal… more
- PeaceHealth (Vancouver, WA)
- **Description** PeaceHealth is seeking an Internal Auditor Senior - Organizational Integrity. This remote role requires the incumbent to work & reside in OR, WA or ... AK by date of hire. Our Internal Auditor Sr is an independent, objective assurance and consulting activity designed to add value and improve an organization's… 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
- Emory Healthcare/Emory University (Atlanta, GA)
- …mentorship and leadership programs + And more! **Description** The Professional Coding Compliance Auditor develops and executes audit, monitoring, and education ... development and delivering educational and training programs for professional billing and clinical compliance based on the latest Federal and State regulations… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …Reporting to the Director, Compliance Audit and Analysis, the Sr. Compliance Auditor will develop and execute audit, monitoring, and education for ... and professional billing, coding and documentation programs that ensure compliance with regulatory standards. Continuously evaluate facility/professional billing … more
- Geisinger (Danville, PA)
- Job Summary The Compliance Auditor position is responsible for supporting the organization's Revenue Management Compliance department in developing, ... implementing, and administering an effective compliance program. Accurately audits and provides compliance research support to physicians, non-physician… more
- Trinity Health (Syracuse, NY)
- …required. Must have 5 or more years' experience as a risk adjustment auditor and educator and/or clinical documentation improvement specialist with a solid ... if needed. Auditing Experience Posting **POSITION PURPOSE:** A Risk Adjustment Auditor Educator is responsible for ensuring accurate coding and documentation in… more
- Veterans Affairs, Veterans Health Administration (Murfreesboro, TN)
- …in the development of guidelines for data quality, consistency, and monitoring for compliance to improve the quality of clinical , financial, and administrative ... is located in the Health Information Management (HIM) section in the Clinical Operations/Health Informatics Service at the Tennessee Valley Healthcare System (TVHS).… more
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