• Senior Clinical Auditor

    Surgery Care Affiliates (Birmingham, AL)
    …as well as support SCA Health' s compliance program . The Senior Clinical Auditor will work with all Support Services departments , as well as interact ... a member of the Regulatory Compliance Team, the Senior Clinical Auditor will conduct compliance focused ...license + 4-5 years of experience as a licensed Registered Nurse or equivalent clinical more
    Surgery Care Affiliates (04/04/25)
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  • Quality Improvement Auditor

    Centene Corporation (New York, NY)
    …findings, including clinical recommendations to assure the delivery of quality services + Lead case reviews to assess the clinical performance provided ... years of nursing or quality improvement experience. **Licenses/Certifications:** Current state's clinical license (LPN, RN , etc.).Pay Range: $55,100.00 -… more
    Centene Corporation (06/04/25)
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  • Clinical Auditor : Appeals…

    Healthfirst (NY)
    …and Responsibilities:** + Conduct quality audits of A&G items cases grievances, pre- service appeals, and post service appeals utilizing appropriate sources of ... classified, and fully resolved in a compliant manner. + Review clinical documentation for accuracy, completeness identifying any discrepancies or non-compliance… more
    Healthfirst (05/02/25)
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  • Clinical Documentation Specialist…

    UNC Health Care (Chapel Hill, NC)
    …Association) certification - AAPC (American Academy of Professional Coders) certification - RN ( Registered Nurse ) license - LPN (Licensed Practical ... are owned or managed that have opted into shared services . This position reports to the HCS Supervisor Coding...across the state to train and shadow round with Clinical Documentation Specialists. The CDS auditor provides… more
    UNC Health Care (04/29/25)
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  • Clinical Audit Analyst

    CommonSpirit Health Mountain Region (Lakewood, CO)
    …and medical experience may substitute. **License/Certifications Requirements** Registered Nurse Preferred State of employment RN license, preferred ... patient care including nurses, surgical technologist, surgeons, anesthesiologists, certified registered nurse anesthetists (CRNA), support specialists, unit… more
    CommonSpirit Health Mountain Region (06/11/25)
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  • ( RN ) HCS-D, COS-C - Registered

    Northwell Health (Westbury, NY)
    …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 ... **Req Number** 128397 Job Description Seeking RN - BSN or MSN candidates with a...- Home Care Coding Specialist-Diagnosis, COS-C Certificate for OASIS Specialist- Clinical . Conducts Home Health Resource Group (HHRG) Validation to… more
    Northwell Health (06/02/25)
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  • ( RN ) Registered Nurse

    Northwell Health (Garden City, NY)
    …combination of education and related experience. 2.Current License to practice as a Registered Professional Nurse in New York State required, plus specialized ... the assignment can be substantiated by the documentation in the Medical Record. Seeking RN - BSN or MSN candidates with a HCS-D - Home Care Coding… more
    Northwell Health (06/13/25)
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  • Registered Nurse - Charge…

    Henry Ford Health System (Troy, MI)
    …audit requests. + Knowledge of billing and charging rules as it relates to clinical services is a plus. + Computer skills (word processing, spreadsheet, ... with department standards regarding productivity and audit quality. CERTIFICATIONS/LICENSURES REQUIRED: Registered Nurse credentialed from the Michigan Board of… more
    Henry Ford Health System (06/17/25)
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  • Sr. Specialist, Quality Auditor (Field…

    Molina Healthcare (Phoenix, AZ)
    …current Licensure under the Arizona State Board of Nursing (BON) + QM BH Nurse : Arizona-licensed registered nurse practitioner licensed as an adult, ... quality monitoring activities, including audits of medical record quality, services , and service sites, health and safety,...psychiatric and mental health nurse , or Arizona-licensed registered nurse more
    Molina Healthcare (05/07/25)
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  • Billing Compliance Auditor

    Elara Caring (Dallas, TX)
    …+ Associate's degree or higher in Nursing + 5 years of experience as a Registered Nurse in Home Health and/or Hospice with coding experience is preferred + ... audits will include, but are not limited to eligibility, billing, coding, and clinical documentation. Duties of the Billing Compliance Auditor include but are… more
    Elara Caring (06/11/25)
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  • Senior Corporate Compliance Auditor

    Fairview Health Services (St. Paul, MN)
    …attention to detail, who enjoys working in a collaborative and team-based environment. A clinical background, eg RN , is a plus, as well as having experience ... and regulatory requirements for multiple specialties, including laboratory and behavioral health services . The Senior Auditor will: + Lead advanced, complex… more
    Fairview Health Services (05/22/25)
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  • Revenue Integrity Nurse Auditor

    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 ... compliance with billing regulations and trends in denials of services due to medical necessity or appropriateness of ...AND/OR CERTIFICATIONS + Current Virginia state license as a Registered Nurse or Registered more
    Childrens Hospital of The King's Daughters (04/25/25)
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  • Inpatient Coding Auditor

    BayCare Health System (Tampa, FL)
    …and Licensures** + **Required:** RHIA/RHIT in conjunction with CCS + **Preferred:** RN , CDIP, CCDS, or clinical degree **Education** + **Required:** associate's ... Team Member who is passionate about providing outstanding customer service to our community. We are looking for an...PM + **Days:** Monday - Friday The **Inpatient** **Coding Auditor ** is a full-time remote position. _Sign on bonuses… more
    BayCare Health System (05/29/25)
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  • Revenue Integrity - Nurse Auditor

    Trinity Health (Ann Arbor, MI)
    …travelling between locations within the region. **MINIMUM QUALIFICATIONS** **Licensure/Certification:** Registered Nurse or Licensed Vocational Nurse / ... Business Service (PBS) center and ensures compliant and complete clinical documentation, assists with denials and related audits, and identifies opportunities… more
    Trinity Health (06/12/25)
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  • Hospital Coding Compliance Auditor

    Emory Healthcare/Emory University (Atlanta, GA)
    …and visitors. **Education and experience requirements:** + Bachelors degree required. + Clinical background preferred (ie, LPN, RN , etc.). + Current Certified ... or expression, pregnancy, age (40 and over), disability, citizenship, genetic information, service in the uniformed services , veteran status or any other… more
    Emory Healthcare/Emory University (04/22/25)
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  • RN Utilization Management Clinical

    The Cigna Group (Sacramento, CA)
    …Other duties as required and related to this role. **Minimum requirements:** + Active unrestricted Registered Nurse ( RN ) license in state or territory of the ... knowledge and acumen to develop models and procedures, and monitor trends, within Nurse Case Management. RN and current unrestricted nursing license required.… more
    The Cigna Group (05/29/25)
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  • RN Nurse Quality Assurance…

    Kelly Services (Lake Mary, FL)
    … Aide Evaluator programs across the United States. **Important Requirements:** Must possess a Registered Nurse ( RN ) license in good standing, with a compact ... or multi-state license OR must possess a Registered Nurse ( RN ) license in...Quality Assurance Auditor , and indirect supervision of Nurse Aide Evaluators (NAEs). **Qualifications:** + Education/Experience: Registered more
    Kelly Services (05/20/25)
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  • Supply Chain Specialist

    Aston Carter (Kansas City, MO)
    …capital planning, sourcing, and price negotiation. + Establish and manage supply and service contracts. + Develop sourcing strategies for clinical supply market ... 5 years of experience in Healthcare Supply Chain or registered nurses with 5+ years of experience who are...Lead negotiations, act as a sourcing expert, contract specialist, auditor , and consultant for clinical categories. +… more
    Aston Carter (06/12/25)
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  • Case Manager, RN or Licensed Behavioral…

    Excellus BlueCross BlueShield (Rochester, NY)
    clinical expertise (ex. Social Work, Behavioral Health, Respiratory Therapy, Registered Dietitian, Registered Nurse , Medical Director, Pharmacist, ... All Levels + Associates degree required. Bachelor's degree preferred. + Active NYS RN or Registered Dietician or Physical Therapist licensure required; or LMSW;… more
    Excellus BlueCross BlueShield (06/18/25)
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  • Clinical Documentation Specialist

    University of Texas Rio Grande Valley (Harlingen, TX)
    …Medicine/ Revenue Cycle FTE1.0 FLSAExempt Scope of Job To promote appropriate clinical documentation through collaboration with the School of Medicine clinical ... process is followed. Description of Duties * Obtains and promotes appropriate clinical documentation through interaction with clinical staff and physicians to… more
    University of Texas Rio Grande Valley (04/28/25)
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