• Provider Auditor ( RN…

    Elevance Health (Miami, FL)
    ** Provider Auditor ** _This position will work...or any combination of education and experience, which would provide an equivalent background. RN , LPN ... determined to recover, eliminate and prevent unnecessary medical-expense spending. The ** Provider Auditor ** conducts on-site reviews of medical charts, medical… more
    Elevance Health (06/07/25)
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  • Clinical Documentation Specialist Auditor…

    UNC Health Care (Chapel Hill, NC)
    …of Professional Coders) certification - RN ( Registered Nurse ) license - LPN ( Licensed Practical Nurse ) license - Advance Practice Provider ... and shadow round with Clinical Documentation Specialists. The CDS auditor provides elbow to elbow support during training and...education and training related to results. 2. Monitor and provide feedback to new-hire CDS, as they progress through… more
    UNC Health Care (04/29/25)
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  • Compliance Auditor , Associate

    UPMC (Pittsburgh, PA)
    …Registered Health Information Technician (RHIT) + Licensed Professional Nurse ( LPN ) or + Registered Nurse ( RN ) + Act 34 **UPMC is an Equal ... **Join UPMC Corporate Finance as a Compliance Auditor , Associate!** Are you detail-oriented and passionate about...non-physician practitioners based on audit results. These sessions will provide education specific to the issues found during audits… more
    UPMC (04/24/25)
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  • Quality Improvement Auditor (Clinical)

    Centene Corporation (New York, NY)
    …nursing or quality improvement experience. **Licenses/Certifications:** Current state's clinical license ( LPN , RN , etc.).Pay Range: $55,100.00 - $99,000.00 per ... clinical documentation, and modify business processes to measure member outcomes. Assess provider performance and quality of care through clinical case reviews. +… more
    Centene Corporation (05/10/25)
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  • Hospital Coding Compliance Auditor

    Emory Healthcare/Emory University (Atlanta, GA)
    …experience requirements:** + Bachelors degree required. + Clinical background preferred (ie, LPN , RN , etc.). + Current Certified Coding Specialist (CCS) ... career and be what you want to be. We provide : + Comprehensive health benefits that start day 1...works with relevant departments to implement. + Ensures required provider compliance training related to inpatient hospital documentation, coding… more
    Emory Healthcare/Emory University (04/22/25)
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  • Clinical Auditor : Appeals and Grievances

    Healthfirst (NY)
    …of appeals and grievances determinations + Additional duties as assigned **Minimum Qualifications:** + LPN or RN license + 1+ years of Appeals and Grievances ... any discrepancies or non-compliance issues + Record/track quality assessment scores and provide feedback to reduce errors and improve processes and performance to… more
    Healthfirst (07/11/25)
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  • Practice Transformation Associate

    CVS Health (Tallahassee, FL)
    …Qualifications** + RHI, RHIT, CRC, or CPC certified Coder or auditor (CMAS) or + RN or LPN or LISW or + Three years' experience in managed care with a ... for members. The Liaison achieves this goal through analyzing and sharing provider performance metrics related to quality, clinical outcomes, coding, and utilization… more
    CVS Health (07/12/25)
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