• Senior Clinical Auditor

    Surgery Care Affiliates (Birmingham, AL)
    …Responsibilities Job Summary: As a member of the Regulatory Compliance Team, the Senior Clinical Auditor will conduct compliance focused clinical audits to ... support SCA Health' s compliance program . The Senior Clinical Auditor will work with all Support...departments/external sources + Work directly with the supervisor to provide timely communication of audit status + Work as… more
    Surgery Care Affiliates (04/04/25)
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  • Clinical Quality Auditor

    Elara Caring (Dallas, TX)
    …Care, at the Right Time, in the Right Place. **Job Description:** The Clinical Quality Auditor performs comprehensive audits within the skilled home health, ... like home, and that's why our teams continue to provide high-quality care to more than 60,000 patients each...have countless ways to make a difference as a Clinical Quality Auditor , by keeping a team… more
    Elara Caring (05/20/25)
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  • Diagnosis Related Group Clinical Validation…

    Elevance Health (Seattle, WA)
    **Diagnosis Related Group Clinical Validation Auditor -RN** **Virtual:** This role enables associates to work virtually full-time, with the exception of required ... essential face-to-face onboarding and skill development. The **Diagnosis Related Group Clinical Validation Auditor ** is responsible for auditing inpatient… more
    Elevance Health (05/22/25)
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  • Clinical Provider Auditor I…

    Elevance Health (Hanover, MD)
    ** Clinical Provider Auditor I** **Supports Payment Integrity & Behavioral Health** _Location:_ This field-based role enables associates to primarily operate ... insightful analytics to improve the delivery of care. The ** Clinical Provider Auditor I** is...or any combination of education and experience, which would provide an equivalent background. + Must achieve coding certification… more
    Elevance Health (05/07/25)
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  • Clinical Provider Auditor II

    Elevance Health (Tampa, FL)
    ** Clinical Provider Auditor II** **Hybrid 1:** This role requires associates to be in-office 1-2 days per week, fostering collaboration and connectivity, ... is determined to recover, eliminate and prevent unnecessary medical-expense spending. ​ The ** CLINICAL PROVIDER AUDITOR II** is responsible for identifying… more
    Elevance Health (05/29/25)
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  • Clinical Documentation Specialist…

    UNC Health Care (Chapel Hill, NC)
    …from entity to entity across the state to train and shadow round with Clinical Documentation Specialists. The CDS auditor provides elbow to elbow support during ... we serve. Summary: This positon trains and audits Inpatient and Outpatient Clinical Documentation Specialists (CDS) across all HCS entities that are owned or… more
    UNC Health Care (04/29/25)
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  • Clinical Auditor : Appeals…

    Healthfirst (NY)
    …classified, and fully resolved in a compliant manner. + Review clinical documentation for accuracy, completeness identifying any discrepancies or non-compliance ... issues + Record/track quality assessment scores and provide feedback to reduce errors and improve processes and...evaluating and analyzing aggregate quality performance data + Apply clinical and critical thinking skills to evaluate the quality… more
    Healthfirst (05/02/25)
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  • Quality Improvement Auditor

    Centene Corporation (New York, NY)
    … documentation, and modify business processes to measure member outcomes. Assess provider performance and quality of care through clinical case reviews. ... + Lead clinical audits for provider medical records both remotely via electronic medical records...quality services + Lead case reviews to assess the clinical performance provided in the provider network,… more
    Centene Corporation (05/10/25)
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  • CDI III Educator Auditor - Full Time - Days

    Mohawk Valley Health System (Utica, NY)
    CDI III Educator Auditor - Full Time - Days Department: CLINICAL DOCUMENTATION IMPROVE Job Summary The CDI III Educator Auditor ( Clinical Documentation ... educational program development, and provider education. Core Job Responsibilities Provider Interaction and Clinical Documentation Review + Creates and… more
    Mohawk Valley Health System (04/23/25)
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  • Inpatient DRG Quality Auditor

    Humana (Des Moines, IA)
    …is a full-time, remote/work-from-home position. **Description** The Inpatient Medical Coding Auditor extracts clinical information from medical records and ... Quality Team is looking is an experienced and well-grounded medical coding auditor to quality review the inpatient hospital claims for proper reimbursement, handle… more
    Humana (05/30/25)
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