- UPMC (Pittsburgh, PA)
- UPMC Health Plan has an exciting opportunity for a Clinical Auditor /Analyst Intermediate! The Clinical Auditor /Analyst Intermediate is an integral part ... establishes and revises better best practice within the department. The Clinical Auditor /Analyst Intermediate creates, maintains and analyzes auditing reports… more
- CGI Technologies and Solutions, Inc. (Dallas, TX)
- **Remote Senior Inpatient Auditor - MS-DRG & Clinical Validation** **Category:** Analytics and Emerging Digital Technologies **Main location:** United States, ... **Employment Type:** Full Time **Position Description:** CGI is seeking a high-caliber MS-DRG Auditor to join our Healthcare Compliance Team. In this role, you will… more
- Baylor Scott & White Health (Dallas, TX)
- …vary based 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 clinical documentation from the Electronic Health Record (EHR) compared...charges. + Hybrid position + Must live in BSWH Service area (Dallas preferred) - will be onsite for… 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 ... Practice Plan) is responsible for reviewing and verifying that all billable services and procedures provided to patients are accurately documented, coded, and… more
- Centene Corporation (Atlanta, GA)
- …findings, including clinical recommendations to assure the delivery of quality services + Lead case reviews to assess the clinical performance provided ... preferred. **Position Purpose:** Lead medical record audits, monitor and analyze clinical documentation, and modify business processes to measure member outcomes.… more
- Insight Global (Plano, TX)
- …years 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 ... 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
- Humana (Columbus, OH)
- …our caring community and help us put health first** The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and ... codes (eg, ICD-10-CM, CPT) to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis… more
- Elevance Health (Richmond, VA)
- **Nurse Auditor Senior - Payment Integrity Complex and Clinical Audit** **Location:** This role enables associates to work virtually full-time, with the ... procedures and educational materials + Acts as liaison with service operations as well as other areas of the...AS in nursing and minimum of 4 years of clinical nursing experience; or any combination of education and… more
- 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 ... Summary: This positon trains and audits Inpatient and Outpatient Clinical Documentation Specialists (CDS) across all HCS entities that...are owned or managed that have opted into shared services . This position reports to the HCS Supervisor Coding… more
- Humana (Jackson, MS)
- …the accuracy, completeness, specificity and appropriateness of procedure codes based on services rendered + Review medical documentation for clinical indicators ... and help us put health first** The Medical Coding Auditor reviews medical claims submitted against medical records provided,...our customers and our company. Through our Humana insurance services and CenterWell healthcare services , we make… more
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