- 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 ... , as well as support SCA Health' s compliance program . The Senior Clinical Auditor will work with all Support Services departments , as well as interact… more
- Astrix Technology (Los Angeles, CA)
- ** Clinical Compliance Auditor ** Clinical Los Angeles, CA, US Pay Rate Low: 100000 | Pay Rate High: 150000 + Added - 04/04/2025 Apply for Job We're partnering ... biotechnology industry, and they're on the lookout for a talented ** Clinical Compliance Auditor ** to join their dynamic team! If you're passionate about ensuring… more
- Elevance Health (Hanover, MD)
- ** Clinical Provider Auditor I** **Supports Payment Integrity & Behavioral Health** _Location:_ This field-based role enables associates to primarily operate in ... and insightful analytics to improve the delivery of care. The ** Clinical Provider Auditor I** is responsible for identifying issues and/or entities that may… more
- Elevance Health (MD)
- ** Clinical Provider Auditor Senior** **Supports Payment Integrity line of business** _Lo_ _cation: This is a field position expected to be in clinic 60% of the ... determined to recover, eliminate and prevent unnecessary medical-expense spending. The ** Clinical Provider Auditor Senior** is responsible for identifying issues… more
- Elevance Health (Seven Fields, PA)
- **JR150201 Behavioral Health Clinical Quality Auditor Analyst Sr** The Behavioral Health Clinical Quality Audit Analyst Sr is a professional-level ... clinical (licensed) position that supports risk management functions. The position is primarily responsible for investigating and reporting on all complaints; it requires some participation in a range of quality management activities including adverse… more
- Translational Research in Oncology (Washington, DC)
- If you are an experienced Senior Clinical Quality Assurance Auditor (internally referred to as Senior Clinical Quality Assurance Manager) who is passionate ... future to the world of today. TRIO is seeking a Senior Clinical Quality Assurance Auditor (internally referred to as Senior Clinical Quality Assurance… 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 ... we serve. Summary: This positon trains and audits Inpatient and Outpatient Clinical Documentation Specialists (CDS) across all HCS entities that are owned or… more
- Healthfirst (NY)
- …classified, and fully resolved in a compliant manner. + Review clinical documentation for accuracy, completeness identifying any discrepancies or non-compliance ... + Assists with evaluating and analyzing aggregate quality performance data + Apply clinical and critical thinking skills to evaluate the quality and effectiveness of… more
- Community Health Systems (Sarasota, FL)
- (Full-Time, Remote) The Clinical Review Analyst is a professionally licensed nurse/LPN who is responsible for effectively managing the denial/appeal process via the ... performance of comprehensive analytic reviews of clinical and claim documentation. The CRA will perform triage,...401k and student loan repayment programs. **Required:** + Experience: Clinical experience in an acute care setting + Education:… more
- Centene Corporation (New York, NY)
- …preferred.** **Position Purpose:** Lead medical record audits, monitor and analyze clinical 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… more
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