- Lyric (Newtown Square, PA)
- …relevant healthcare experience as a medical coder, medical claims processor medical auditor , clinical editing analyst, or payment or medical policy analyst. ? ... billing office with multi-specialty practices preferred. + Previous experience as a nurse is a plus. + Current working knowledge of pre-payment editing and… more
- Humana (Washington, DC)
- …a part of our caring community and help us put health first** The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record ... is complete, compliant and accurate to support optimal reimbursement. The Nurse Auditor 2 work assignments are varied and frequently require interpretation and… 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 ... AND/OR CERTIFICATIONS + Current Virginia state license as a Registered Nurse or Registered Nurse holding a valid Compact State license. + Certified Professional… more
- Providence (WA)
- …for conducting clinical quality audits for the Quality Department. The auditor identifies and coordinates clinical audits to determine potential areas for ... the audit season, which runs approximately February through mid-May. The RN auditor will successfully complete HEDIS training prior to performing chart abstractions.… more
- Trinity Health (Livonia, MI)
- …and utilization management. + Customer service background is required. **Preferred:** + Registered Nurse + Bachelor's degree + Two plus (2+) years of charge audit, ... managed care or comparable patient payment processing experience preferred. + AAPC,AHIMA, CHRI certification/membership. + Outpatient CDI experience. + Working knowledge of Electronic Health Records (EHR). **Our Commitment** Rooted in our Mission and Core… 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
- Northwell Health (Glen Cove, NY)
- …and related experience. 2.Current License to practice as a Registered Professional Nurse in New York State required, plus specialized certifications as needed. 3. ... Rehab nursing experience, preferred. 4. ICD-10 medical coding experience, highly preferred. *Additional Salary Detail The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful… more
- Northwell Health (Westbury, NY)
- …job entry date. + Current License to practice as a Registered Professional Nurse in New York State required, plus specialized certifications as needed. *Additional ... Salary Detail The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future.When… more
- Corewell Health (Grand Rapids, MI)
- …relevant experience: + Legal or regulatory field; health care focus desirable + Compliance auditor , nurse auditor , or other audit function + Project ... management/program development and implementation + ICD-9 or ICD-10 and CPT 4 coding or medical record audit and review (facility and/or professional) + Education of clinical and non-clinical staff including Medical Staff and mid-level providers + Conducting… more
- Trinity Health (Livonia, MI)
- …to intra-departmental Revenue Integrity colleagues including areas of opportunity. Assist Nurse Auditor and/or other stakeholders with denial related charge ... RHIA, RHIT, CCS, CPC/COC or other coding credentials _and/or Licensed Vocational Nurse / Licensed Practical Nurse licensure_ is required. CHC (Healthcare… more
- Trinity Health (Livonia, MI)
- …to intra-departmental Revenue Integrity colleagues including areas of opportunity. Assist Nurse Auditor and/or other stakeholders with denial related charge ... RHIA, RHIT, CCS, CPC/COC or other coding credentials _and/or Licensed Vocational Nurse / Licensed Practical Nurse licensure_ is required. CHC (Healthcare… more
- BJC HealthCare (St. Louis, MO)
- …collaborating within a team setting? BJC Home Care is looking for an licensed practical nurse Scheduler, auditor and field visits to assist our patients and our ... within the scope of practice for the Licensed Practical Nurse . + Under the direction of the Registered ...Nurse . + Under the direction of the Registered Nurse , provides patient teaching and discharge planning. Participates in… more
- UPMC (Pittsburgh, PA)
- **Join UPMC Corporate Compliance as an Intermediate Compliance Auditor !** Are you passionate about ensuring accuracy and compliance in healthcare documentation and ... **UPMC Corporate Compliance** is seeking a dedicated and detail-oriented **Intermediate Compliance Auditor ** to join our team! This position will be based out of… more
- Robert Half Accountemps (Boston, MA)
- Description Job Title: Medical Claims Auditor - RN Auditor Location: Massachusetts - 90% Remote Job Type: 1 Year Contract - Potential for Perm Hire Hours: 40 ... Start Date: December 1, 2025 Job Description We are seeking a qualified Auditor with healthcare experience to support Program Integrity activities for a state… more
- Elevance Health (Las Vegas, NV)
- **Diagnosis Related Group Clinical Validation Auditor -RN (CDI, MS-DRG, AP-DRG and APR-DRG)** **Virtual:** This role enables associates to work virtually full-time, ... granted as required by law. The **Diagnosis Related Group Clinical Validation Auditor ** is responsible for auditing inpatient medical records to ensure clinical… more
- CVS Health (Phoenix, AZ)
- …heart, each and every day. **Position Summary** The **Healthcare Quality Management Auditor ** participates in the development and ongoing implementation of QM ( ... in QM meetings. **Required Qualifications** + Active RN (Registered Nurse ) or LPN (Licensed Practical Nurse ) license, valid in the state of Arizona. + 1+… more
- AdventHealth (Orlando, FL)
- …The Surgical and Procedural Services Safety and Regulatory Compliance Auditor evaluates the surgical and procedural environment, policies, and procedures ... Florida or multi state license as a Licensed Practical Nurse **or** + RN current valid State of Florida...of Florida or multi state license as a Registered Nurse **or** + CST, Certified Surgery Technician (CST) from… more
- Insight Global (South Jordan, UT)
- Job Description Insight Global is seeking a DRG Validation Auditor for one of our clients to sit 100% remote. This person should have an extensive background in ... and coding terminology. Expert coding knowledge (DRG & ICD-10) Registered Nurse RN (must be inpatient) WITH coding/clinical documentation certification (2 years… more
- UNC Health Care (Chapel Hill, NC)
- …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 ... (American Academy of Professional Coders) certification - RN (Registered Nurse ) license - LPN (Licensed Practical Nurse )...(Registered Nurse ) license - LPN (Licensed Practical Nurse ) license - Advance Practice Provider (NP or PA)… more
- GE Aerospace (Hooksett, NH)
- …team at ERAC, a corporate holding of GE Aerospace, as a Reinsurance Auditor and lead audits that drive transparency, innovation, and integrity across reinsurance ... and prescription drug coverage; access to a Health Coach, a 24/7 nurse -based resource; and access to the Employee Assistance Program, providing 24/7 confidential… more
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