- Humana (Washington, DC)
- **Become a part of our caring community and help us put health first** The Nurse Auditor 2 performs clinical audit/validation processes to ensure that ... the appropriate courses of action. The Nurse Auditor 2 validates and interprets medical record...us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and… more
- Providence (WA)
- …benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits ( medical , dental, vision), life insurance, disability ... for conducting clinical quality audits for the Quality Department. The auditor identifies and coordinates clinical audits to determine potential areas for… 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 ... reimbursement to the health system from third party payers. Reports to the...regulations and trends in denials of services due to medical necessity or appropriateness of services. + Conducts compliance,… more
- Northwell Health (Westbury, NY)
- …Coding Specialist-Diagnosis, COS-C Certificate for OASIS Specialist-Clinical. Conducts Home Health Resource Group (HHRG) Validation to ensure the diagnostic ... to the assignment can be substantiated by the documentation in the Medical Record. Job Responsibility + Audits and reviews Medicare/non-Medicare charts to ensure… more
- Northwell Health (Glen Cove, NY)
- …to the assignment can be substantiated by the documentation in the Medical Record. Job Responsibility 1.Leverages clinical expertise to identify and validate DRG ... and related experience. 2.Current License to practice as a Registered Professional Nurse in New York State required, plus specialized certifications as needed. 3.… more
- Elevance Health (Las Vegas, NV)
- …is granted as required by law. The **Diagnosis Related Group Clinical Validation Auditor ** is responsible for auditing inpatient medical records to ensure ... **Diagnosis Related Group Clinical Validation Auditor -RN (CDI, MS-DRG, AP-DRG and APR-DRG)** **Virtual:** This...an impact:** + Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines, and objectivity in… more
- UPMC (Pittsburgh, PA)
- …Coder (CIC) + Certified Evaluation & Management Coder (CEMC) + Certified Professional Medical Auditor (CPMA) + Certified Professional Coder (CPC) + Certified ... Medical Coder (CMC) + OR Registered Health ...Health Information Technician (RHIT) + OR Licensed Professional Nurse (LPN) + Registered Nurse (RN) Required:… more
- CVS Health (Phoenix, AZ)
- …Strong relationship building skills. + Previous experience in an outpatient behavioral health environment. + Previous experience working with medical records ... At CVS Health , we're building a world of health...and every day. **Position Summary** The **Healthcare Quality Management Auditor ** participates in the development and ongoing implementation of… more
- UNC Health Care (Chapel Hill, NC)
- …inclusive organization with over 40,000 teammates, whose mission is to improve the health and well-being of the unique communities we serve. Summary: This positon ... 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… more
- AdventHealth (Orlando, FL)
- …Days Off from Day One Career Development Whole Person Wellbeing Resources Mental Health Resources and Support **Our promise to you:** Joining AdventHealth is about ... hospital, 1,368-bed AdventHealth Orlando + We offer great benefits with immediate Health Insurance coverage + Career growth and advancement potential + Serves as… 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 ... experience, preferably in the healthcare industry. + **Active New Jersey Registered Nurse (RN) License required.** **Skills:** + Knowledge of managed care principles… more
- GE Aerospace (Hooksett, NH)
- …include medical , dental, vision, and prescription drug coverage; access to a Health Coach, a 24/7 nurse -based resource; and access to the Employee Assistance ... a corporate holding of GE Aerospace, as a Reinsurance Auditor and lead audits that drive transparency, innovation, and...term care insurance claim experience + Working knowledge of medical terminology and medical impairments related to… more
- Centene Corporation (Jefferson City, MO)
- …Mental Health Counselor (LMHC), Licensed Professional Counselor (LPC), Registered Nurse (RN), or Licensed Practical Nurse (LPN) Pay Range: $55,100.00 ... one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national… more
- Henry Ford Health System (Detroit, MI)
- …most respected academic medical centers and is leading the Future of Health : Detroit, a $3 billion investment anchored by a reimagined Henry Ford academic ... lab. PRINCIPLE DUTIES AND RESPONSIBILITIES: 1. Conducts audits of daily electronic medical records for accuracy of implants, surgical and recovery time stamps. 2.… 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 ... + Additional Licenses and Certifications Current active State license as a Registered Nurse , Nurse Practitioner, Physicians Assistant, Medical Physician, or… more
- Molina Healthcare (Syracuse, NY)
- …and process audits as needed. * Audits for clinical gaps in care from a medical and/or behavioral health perspective to ensure member needs are being met. * ... Performs audits in utilization management, care management, member assessment, behavioral health , and/or other clinical teams, and monitors clinical staff for… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Work, Behavioral Health , Respiratory Therapy, Registered Dietitian, Registered Nurse , Medical Director, Pharmacist, Geriatrics, etc.) to ensure continuity ... activities in accordance with departmental, corporate, NYS Department of Health (DOH), Centers for Medicaid & Medicare Services (CMS),...NYS DOH, CMS, NCQA, and HEDIS, serving as internal auditor within the group. + Responsible for all aspects… more
- Baystate Health (Springfield, MA)
- …below represent the base salaries for all positions at a given grade across the health system. Typically, a new hire can expect a starting salary somewhere in the ... employees. Minimum - Midpoint - Maximum $16.68 - $20.39 - $25.36 **Baystate Health , a nationally recognized leader in healthcare quality and safety, is looking for… more
- Baystate Health (Springfield, MA)
- …below represent the base salaries for all positions at a given grade across the health system. Typically, a new hire can expect a starting salary somewhere in the ... employees. Minimum - Midpoint - Maximum $16.68 - $20.39 - $25.36 **Baystate Health , a nationally recognized leader in healthcare quality and safety, is looking for… more
- Baystate Health (Springfield, MA)
- …below represent the base salaries for all positions at a given grade across the health system. Typically, a new hire can expect a starting salary somewhere in the ... employees. Minimum - Midpoint - Maximum $16.02 - $19.28 - $23.65 **Baystate Health , a nationally recognized leader in healthcare quality and safety, is looking for… more