- Actalent (West Des Moines, IA)
- Nurse Auditor Job Description This role requires a...Iowa with a hybrid schedule of 3 days in-office and 2 days remote. The work hours are Monday to Friday, ... thorough understanding of standard medical coding, including CPT, ICD-10, and HCPCS. The Nurse Auditor is responsible for adjudicating claims to comply with… more
- Trinity Health (Ann Arbor, MI)
- …between locations within the region. **MINIMUM QUALIFICATIONS** **Licensure/Certification:** Registered Nurse or Licensed Vocational Nurse / Licensed Practical ... of nursing, plus at least four (4) years of nursing experience and two ( 2 ) years of charge audit, managed care or comparable patient payment processing experience… more
- Northwell Health (Westbury, NY)
- …experience. 2 .Current License to practice as a Registered Professional Nurse in New York State required, plus specialized certifications as needed. *Additional ... 1.Leverages clinical expertise to identify and validate DRG code assignment. 2 .Full review of CDI suggested code changes 3.Demonstrates comprehensive knowledge of… more
- Northwell Health (Westbury, NY)
- …Degree in Nursing, preferred. Must be enrolled in an accredited BSN program within two ( 2 ) years and obtain a BSN Degree within five (5) years of 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… 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… 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 ... accuracy and recommends education and training related to results. 2 . Monitor and provide feedback to new-hire CDS, as...(American Academy of Professional Coders) certification - RN (Registered Nurse ) license - LPN (Licensed Practical Nurse )… 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 level ... Additional Licenses and Certifications Current active State license as a Registered Nurse , Nurse Practitioner, Physicians Assistant, Medical Physician, or an… more
- Baystate Health (Springfield, MA)
- …MA.** **SCHEDULE:** + Part time, 24 hours/week, 3rd Shift + Hours: 7pm-7:30am + 2 shifts per week, rotating days and weekends required **LOCATION** : + Baystate Main ... needs of all communities in need. **QUALIFICATIONS:** + HS Diploma/GED + 1- 2 years experience in customer service (healthcare setting preferred) + Medical… more
- Baystate Health (Springfield, MA)
- …or equivalent required + Prior administrative experience strongly preferred + 1- 2 years' experience in customer service (healthcare setting preferred) + Ability ... be applicable to this role.** **Summary:** Reports to the Nurse Manager but daily activities are coordinated by the...breaks and meals to ensure constant flow of ADTs. ** 2 )** Proficiently and accurately utilizes the following computer applications… more
- SSM Health (MO)
- …Performs as a vital member of the interdisciplinary care team member, an auditor , and an educator ensuring medical records are complete and clinical documentation ... + Or + Physician - Regional MSO Credentialing + Or + Registered Professional Nurse (RN) - Illinois Department of Financial and Professional Regulation (IDFPR) + Or +… more
- Medical Mutual of Ohio (OH)
- …companies based in Ohio. We provide peace of mind to more than 1. 2 million members through our high-quality health, life, disability, dental, vision and indemnity ... To include data documentation, compilation, reconciliation, and research.Works directly external HEDIS/NCQA auditor to resolve any items on Issue Log. + Reviews data… more
- AdventHealth (Altamonte Springs, FL)
- …practitioners, nursing, care management and quality abstracters. The Quality Auditor Manager adheres to strict departmental and organizational goals, objectives, ... Care, post-acute care unit, or Emergency Department experience. . Two ( 2 ) years of Clinical Documentation Specialist experience **LICENSURE, CERTIFICATION OR… more
- HCA Healthcare (San Antonio, TX)
- …true discrepancy and complete incident reports as required. You will review RX Auditor report and generate investigation reports for nurse managers/directors to ... course sponsored by an ACPE accredited provider. + Minimum 2 years of hospital experience required + Minimum 1...private patient rooms and eight VIP rooms with private nurse stations, Methodist Hospital | Landmark delivers a true… more
- NCH (Naples, FL)
- …Specialist for educational opportunities/outcomes. * Collaborates with CDI liaison/quality auditor when educational needs are identified from second level reviews. ... required; Bachelor's Degree preferred. * Licensed as a Registered Nurse in the state of Florida. * 5+ years...or previous CDI experience in an academic institution with 2 + years of leadership experience. * Team leading experience… more
- Excellus BlueCross BlueShield (Dewitt, NY)
- …Social Work, Behavioral Health, Respiratory Therapy, Registered Dietitian, Registered Nurse , Medical Director, Pharmacist, Geriatrics, etc.) to ensure continuity and ... NYS DOH, CMS, NCQA, and HEDIS, serving as internal auditor within the group. + Responsible for all aspects...addition to Level I Qualifications) + A minimum of 2 years in case management position. + Case Management… more
- Covenant Health Inc. (Knoxville, TN)
- …Covenant Health standards of Telephone Excellence policy. + Refers patient accounts to nurse auditor upon request by patient or insurance company, and monitors ... possessing a HS diploma or GED. Minimum Experience: One (1) to two ( 2 ) years experience in Patient Accounts/Customer Service is required. Must meet all requirements… more
- Ochsner Health (New Orleans, LA)
- …providers , on- site case management team, as well as LPN/RN or Nurse Auditor in the Pre-Service department. + Performs Pre-Service collection estimation ... amount of force constantly (Constantly: activity or condition exists 2 /3 or more of the time) to move objects....requires walking or standing to a significant degree; or ( 2 ) when it requires sitting most of the time… more
- HCA Healthcare (San Antonio, TX)
- …true discrepancy and complete incident reports as required. You will review RX Auditor report and generate investigation reports for nurse managers/directors to ... of Pharmacy or a course sponsored by an ACPE accredited provider. + Minimum 2 years of hospital experience required + Minimum 1 year sterile compounding experience… more