- Robert Half Accountemps (Boston, MA)
- …stone into leadership, healthcare administration, or corporate healthcare roles. Requirements Featured Opportunity: RN Auditor / Clinical Reviewer + Work for ... impactful non- clinical roles - including chart review, clinical auditing, utilization management, quality assurance, and...RN license and at least 2 years of clinical experience Who We're Looking For: + Active … more
- Actalent (Atlanta, GA)
- Job Title: Quality Improvement Auditor - Fully remote Job Description The Quality Improvement Auditor will lead medical record audits, monitor and ... member outcomes. This role involves assessing provider performance and quality of care through clinical case reviews....of quality improvement experience or similar to Quality Improvement Auditor . + Audit experience, including… more
- Insight Global (South Jordan, UT)
- …terminology. Expert coding knowledge (DRG & ICD-10) Registered Nurse RN (must be inpatient) WITH coding/ clinical documentation certification (2 years in ... Job Description Insight Global is seeking a DRG Validation Auditor for one of our clients to sit 100%...clinical documentation) OR IF NOT A NURSE : Degree in RHIM, RHIA, RHIT with medical coding… more
- AdventHealth (Orlando, FL)
- …+ RN current valid State of Florida or multi state license as a Registered Nurse **or** + CST, Certified Surgery Technician (CST) from the National Board of ... each position may vary based on geographical location. **Category:** Quality / Clinical Effectiveness **Organization:** AdventHealth Orlando **Schedule:** Full-time… 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 ... focus audits and reports findings. + Serves as a clinical resource for coding / denial management and customer...AND/OR CERTIFICATIONS + Current Virginia state license as a Registered Nurse or Registered … more
- Catholic Health Initiatives (Chattanooga, TN)
- …area of focus. Additionally the role will assist with educating providers on quality opportunities as well. Clinical background preferred but not required. ... **Job Summary and Responsibilities** **Job Summary / Purpose** The Sr Coding Compliance Auditor is responsible for reviewing chart notes for proper coding with an… 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 ... ICD-10-CM/PCS coding, DRG assignments, and supporting clinical documentation. This includes evaluating present on admission (POA)...any other relevant data to ensure coding accuracy. The auditor is also responsible for writing and defending appeal… more
- Excellus BlueCross BlueShield (Dewitt, NY)
- … clinical expertise (ex. Social Work, Behavioral Health, Respiratory Therapy, Registered Dietitian, Registered Nurse , Medical Director, Pharmacist, ... quality health care services. Examples may include: Utilization Management, Quality , Behavioral Health, Pharmacy, Registered Dietitian and Respiratory… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …and represents non- clinical staff in discussions with Medical Directors and/or clinical consultants. + Serves as an internal auditor /peer reviewer for new ... + Current NYS RN license with a minimum of three years clinical experience; medical/surgical background preferred. + Current CPC designation or must obtain CPC… more
- Catholic Health (Buffalo, NY)
- …finance, business management, operational analysis, information systems or related field + Registered Nurse with a four (4) year degree and Unrestricted ... role of management and oversight of team Summary: The Clinical Denials and Appeals, Clinical Supervisor is...NYS RN license, preferred + Holds, or will obtain within… more
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