- Guthrie (Sayre, PA)
- Option to be Hybrid/Remote. Summary: A senior level compliance coding auditor conducting assessments in accordance with The Guthrie Clinic's policies and ... accepted guidelines for medical coding. Works closely with the Compliance Officer and Compliance coding Audit Coordinator...(RHIA, RHIT, or CCS) or AAPC (CPC) required + RN /LPN or CPMA preferred + Required to sit for… more
- Saint Francis Health System (Tulsa, OK)
- …**to login and apply.** Full Time Days Job Summary: The Compliance Nurse Auditor assists with and supports ... therefrom. Licensure, Registration and/or Certification: Valid multi-state or State of Oklahoma Registered Nurse License. Work Experience: Minimum 3 years of… more
- 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 ... substantiated by the documentation in the Medical Record. Seeking RN candidates with a HCS-D - Home Care Coding...charts to ensure that proper standards are maintained in compliance with Federal and State regulations. 5.Applies coding rules… more
- US Tech Solutions (Newark, NJ)
- …of related experience, preferably in the healthcare industry. + **Active New Jersey Registered Nurse ( RN ) License required.** **Skills:** + Knowledge of ... months contract with potential extends or Convert** **Job Description:** + The HEDIS Nurse Auditor is responsible for conducting quality audits related to state… more
- Baylor Scott & White Health (Dallas, TX)
- …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 analyzing ... tasks in clinical departments/functions. + Evaluate clinical documentation for compliance , meeting all regulations stipulated by federal and state...least (2) two years of relevant work experience. + Registered Nurse License. As a health care… more
- Molina Healthcare (WA)
- …RN may be preferred for specific roles) + Active, unrestricted Certified HEDIS Compliance Auditor (CHCA) To all current Molina employees: If you are ... implements new and existing healthcare quality improvement activities to maintain compliance with quality program requirements and reporting and monitoring for key… more
- LA Care Health Plan (Los Angeles, CA)
- …Fraud Examiner (CFE) Certified HealthCare Compliance (CHC) Certified Internal Auditor (CIA) Certified Coder, RN , MD, PharmaD, or equivalent Required ... Director, Compliance on Special Investigations Unit and Fraud, Waste...required to achieve that purpose. Job Summary The Director, Compliance on Special Investigations and Fraud, Waste and Abuse… more
- Stanford Health Care (Palo Alto, CA)
- …billing practices. + Proficient EXCEL, WORD, PowerPoint skills **Licenses and Certifications** + RN - Registered Nurse - State Licensure And/Or Compact ... is a Stanford Health Care job.** **A Brief Overview** The Charge Auditor performs auditing activities, including complex cases that require extensive research,… 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 ... timely manner. + Prepares trend and other reports for compliance audits and charge processes. + Serves as a...AND/OR CERTIFICATIONS + Current Virginia state license as a Registered Nurse or Registered … more
- Molina Healthcare (NE)
- …Nursing License ( RN may be preferred for specific roles) + Certified HEDIS Compliance Auditor (CHCA) + Basic SQL experience To all current Molina employees: ... If you are interested in applying for this position, please apply through the intranet job listing Molina Healthcare offers a competitive benefits and compensation package Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V \#PJCorp \#LI-AC1 Pay… more
- UNC Health Care (Chapel Hill, NC)
- …Association) certification - AAPC (American Academy of Professional Coders) certification - RN ( Registered Nurse ) license - LPN (Licensed Practical ... 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
- Mount Sinai Health System (New York, NY)
- **Job Description** **Clinical Revenue Auditor -CDM Patient Financial Services-Corporate-Full-Time-Days- Hybrid.** The Clinical Revenue Auditor for the Mount ... a key role in ensuring the financial health and compliance of the organization and bridges the gap between...**Licensing and Certification Requirements** : + Current NYS licensure ( RN , OT, PT, SLP, PA, Social Worker, Laboratory Technologist,… more
- Community Health Systems (Franklin, TN)
- **Job Summary** The DRG Denials Auditor conducts hospital inpatient DRG denial audits for both RAC and non-RAC accounts, reviewing patient records for accuracy in ... discharge disposition, and any other relevant data to ensure coding accuracy. The auditor is also responsible for writing and defending appeal letters to payers with… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Revenue Integrity Auditor Full Time, 80 Hours Per Pay Period, Day Shift Covenant Health Overview: Covenant Health is the region's top-performing healthcare ... Position Summary: Performs complex level professional internal auditing work. Work involves compliance audit projects for Covenant Health entities as they relate to… more
- University of Washington (Seattle, WA)
- **Job Description** The senior healthcare auditor is responsible for the completion of internal audits within the clinical integrated parts of the University of ... ownership or membership interest. Senior auditors plan and conduct financial, operational, compliance and system audits. They are expected to have internal audit… more
- Insight Global (Plano, TX)
- …working in an acute care setting or a third-party vendor as a DRG Auditor or Clinical Documentation Specialist (CDS). -CCS Certification RN or BSN RHIT or RHIA ... DRG Auditors to join a remote healthcare organization. The DRG Revenue Integrity Auditor will perform Diagnostic Related Group (DRG) validation and quality audits on… more
- Centene Corporation (Jefferson City, MO)
- …Social Worker (LCSW), Licensed Mental Health Counselor (LMHC), Licensed Professional Counselor (LPC), Registered Nurse ( RN ), or Licensed Practical Nurse ... the use of audit process and tools + Facilitate compliance with the auditing process + Act as a...IN MISSOURI **Ideal candidate will be a Licensed Practical Nurse (LPN) with auditing experience.** **Education/Experience:** Bachelor's degree in… more
- Elevance Health (Atlanta, GA)
- ** Nurse Auditor Senior - Payment Integrity Complex and Clinical Audit** **Location:** This role enables associates to work virtually full-time, with the ... determined to recover, eliminate and prevent unnecessary medical-expense spending. The ** Nurse Audit Senior** will be responsible for identifying, monitoring, and… more
- Banner Health (AZ)
- …employment settings by including remote and hybrid opportunities. As a **Licensed Practical Nurse (LPN)** for **Banner Health Plans** , you will be an integral part ... High Volume Specialists (HVS). This position is also responsible for assisting the QM RN with the investigation and research of quality of care concerns that have… more
- St. Luke's University Health Network (Allentown, PA)
- …Works inside with adequate lighting, comfortable temperature and ventilation. EDUCATION: Registered Nurse required, BSN preferred. Current license required. . ... regardless of a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data… more