- 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 ... team:** + Reviews concurrent and retrospective medical record for documentation compliance including completeness and accuracy for severity of illness (SOI), risk… more
- Centene Corporation (Jefferson City, MO)
- …staff at the health plan in the use of audit process and tools + Facilitate compliance with the auditing process + Act as a consultant related to system auditing to ... RESIDE IN MISSOURI **Ideal candidate will be a Licensed Practical Nurse (LPN)** **Education/Experience:** Bachelor's degree in related field or equivalent… more
- Virtua Health (Mount Laurel, NJ)
- …over 2,850 skilled and compassionate doctors, physician assistants, and nurse practitioners equipped with the latest technologies, treatments, and techniques ... being processed appropriately. Responsible for developing, implementing and maintaining compliance plan for pro-fee coding and abstracting. Position Responsibilities:… more
- Trinity Health (Livonia, MI)
- …productivity standards Maintains compliance with regulatory requirements Assist Nurse Auditor and/or Coordinator with denial coordination process; including ... coding credentials and/or Licensed Vocational Nurse / Licensed Practical Nurse licensure is required. CHC (Healthcare Compliance Certification) preferred… more
- AdventHealth (Altamonte Springs, FL)
- …with physicians, nursing and HIM coders. The CDI Quality & Compliance Team Leader strategically facilitates and obtains appropriate and quality physician ... practitioners, nursing, care management and quality abstracters. The Quality Auditor Manager adheres to strict departmental and organizational goals, objectives,… more
- Medical Mutual of Ohio (OH)
- …To include data documentation, compilation, reconciliation, and research.Works directly external HEDIS/NCQA auditor to resolve any items on Issue Log. + Reviews data ... sources to ensure accuracy and validity in compliance with HEDIS technical specifications, policies and operating procedures....planning coordination and facilitation. Works with IT and Clinical Nurse staff to aid in the loading of HEDIS… more
- Houston Methodist (Houston, TX)
- …programs; works across the system to assess, measure, and report compliance with standards; and develops, implements and evaluates strategies to promote ... of evidence-based best practices and standardization to enhance system-wide compliance . **PEOPLE ESSENTIAL FUNCTIONS** + Collaborates and effectively communicates… 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 ... hospital personnel politely and appropriately. You will perform and monitor compliance for quality control and performance improvement functions as assigned. You… 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 ... apply to the assigned area of responsibility and ensures compliance with all such laws, regulations and standards. This...and standards. This employer maintains and complies with its Compliance & Privacy Program and Standards of Conduct, including… 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 ... guidelines and other Third Party Payor requirements assuring departmental compliance . + Recognizes situations, which necessitate supervision and guidance, seeks… more