- Guthrie (Sayre, PA)
- Option to be Hybrid/Remote. Summary: A senior level compliance coding auditor conducting assessments in accordance with The Guthrie Clinic's policies and ... accepted guidelines for medical coding. Works closely with the Compliance Officer and Compliance coding Audit Coordinator...(RHIA, RHIT, or CCS) or AAPC (CPC) required + RN /LPN or CPMA preferred + Required to sit for… more
- Molina Healthcare (Rockford, IL)
- …RN may be preferred for specific roles) + Active, unrestricted Certified HEDIS Compliance Auditor (CHCA) To all current Molina employees: If you are ... and implementation of NCQA accreditation surveys and federal/state QI compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Senior Specialist, Quality Interventions /… more
- Northwell Health (Garden City, NY)
- …combination of education and related experience. 2.Current License to practice as a Registered Professional Nurse in New York State required, plus specialized ... substantiated by the documentation in the Medical Record. Seeking RN candidates with a HCS-D - Home Care Coding...charts to ensure that proper standards are maintained in compliance with Federal and State regulations. 5.Applies coding rules… more
- US Tech Solutions (Newark, NJ)
- …of related experience, preferably in the healthcare industry. + **Active New Jersey Registered Nurse ( RN ) License required.** **Skills:** + Knowledge of ... months contract with potential extends or Convert** **Job Description:** + The HEDIS Nurse Auditor is responsible for conducting quality audits related to state… more
- Molina Healthcare (WA)
- …RN may be preferred for specific roles) + Active, unrestricted Certified HEDIS Compliance Auditor (CHCA) To all current Molina employees: If you are ... implements new and existing healthcare quality improvement activities to maintain compliance with quality program requirements and reporting and monitoring for key… more
- LA Care Health Plan (Los Angeles, CA)
- …Fraud Examiner (CFE) Certified HealthCare Compliance (CHC) Certified Internal Auditor (CIA) Certified Coder, RN , MD, PharmaD, or equivalent Required ... Director, Compliance on Special Investigations Unit and Fraud, Waste...required to achieve that purpose. Job Summary The Director, Compliance on Special Investigations and Fraud, Waste and Abuse… more
- Robert Half Accountemps (Boston, MA)
- …to travel locally as needed + Strong analytical, organizational, and communication skills + RN ( Registered Nurse ) + Experience working in a Program Integrity ... Description Job Title: Medical Claims Auditor - RN Auditor ...desk and onsite audits of healthcare providers to ensure compliance with contractual standards and regulatory requirements. Responsibilities +… more
- Humana (Springfield, IL)
- …each day between 6AM and 9AM in their home time zone. **Required Qualifications** + Active Registered Nurse ( RN ) license in the state they reside. + Minimum ... caring community and help us put health first** The Nurse Auditor 2 performs clinical audit/validation processes...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Stanford Health Care (Palo Alto, CA)
- …billing practices. + Proficient EXCEL, WORD, PowerPoint skills **Licenses and Certifications** + RN - Registered Nurse - State Licensure And/Or Compact ... is a Stanford Health Care job.** **A Brief Overview** The Charge Auditor performs auditing activities, including complex cases that require extensive research,… 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 ... timely manner. + Prepares trend and other reports for compliance audits and charge processes. + Serves as a...AND/OR CERTIFICATIONS + Current Virginia state license as a Registered Nurse or Registered … more