- 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) with auditing experience.** **Education/Experience:** Bachelor's degree in related… more
- Molina Healthcare (Bronx, NY)
- …functional areas in alignment with regulatory requirements - ensuring quality compliance and desired member outcomes. Contributes to overarching strategy to provide ... behavioral health, and/or other clinical teams, and monitors clinical staff for compliance with National Committee for Quality Assurance, Centers for Medicare and… more
- Naven Health (Nashville, TN)
- …**Preferred Qualifications & Interests (PQIs)** + Previous experience as a Quality Assurance Nurse or Chart Review Auditor + Knowledge and understanding of TJC ... the patients we serve. **Job Description Summary:** The Quality Assurance Chart Review Nurse is responsible for the review of assigned clinical records. The Quality… more
- Clark County, NV (Las Vegas, NV)
- GUARDIANSHIP COMPLIANCE INVESTIGATOR I/II Print (https://www.governmentjobs.com/careers/clarkcounty/jobs/newprint/5151944) Apply GUARDIANSHIP COMPLIANCE ... is seeking qualified candidates to apply for the Guardianship Compliance Investigator I/II position. This position performs complex document...retail or mail order fills) + 24/7 Telephone Advice Nurse - no employee cost + Teledoc, Doctoroo, and… more
- University of Southern California (Alhambra, CA)
- …to evaluate department charge processes to improve charge capture and coding compliance . The Senior RI Specialist also coordinates with Keck Medical Center of ... USC Administration, IS, Compliance , Clinical Informatics and Integration personnel on technology projects...and provides leadership by providing direction to the revenue auditor team to all entities of Keck Medical Center… more
- GE Vernova (Wilmington, NC)
- …resources. + Maintain and develop applications/software solutions for continued compliance and improvements including administration and deployment of software ... willingness to complete qualification and certification as a Lead Auditor . + Availability and willingness for periodic travel to...access to Health Coach from GE Vernova, a 24/7 nurse -based resource; and access to the Employee Assistance Program,… more
- St. Luke's University Health Network (Allentown, PA)
- …coding determination made by the government or commercial payors, or their auditor representative. + Facilitate clinical chart reviews to assist with supporting ... + Participate in Administrative Law Judge (ALJ) hearings and/or formal meetings with auditor or payor representatives in defense of coding appeals, as needed. +… more
- Trinity Health (Livonia, MI)
- …to intra-departmental Revenue Integrity colleagues including areas of opportunity. Assist Nurse Auditor and/or other stakeholders with denial related charge ... coding credentials _and/or Licensed Vocational Nurse / Licensed Practical Nurse licensure_ is required. CHC (Healthcare Compliance Certification) preferred.… more
- GE Vernova (Schenectady, NY)
- …- Rigorously execute the supplier evaluation process, including quality & compliance audits / assessments to ensure that only appropriately qualified suppliers ... + Provide technical guidance to suppliers to assure product/process compliance with engineering drawings and specifications + Work closely...such as from ASTM, ASME etc + ISO Lead auditor certified by 3rd party registrar or accepted internal… more