FULL_TIME

FEED

HOUR

By applying to our jobs you agree to receive calls, AI-generated calls, text messages, or emails from Pyramid Consulting, Inc. and its affiliates, and contracted partners. ICU, Critical Care, Emergency Department, Hospitalist, Case Management, Utilization Review, or CDI experience.

Pyramid, Inc

Clinical Documentation Consultant (CDI) DRG Validation / Auditor

UNKNOWN

Skills: Required Training: Registered Records Administrator or Technician, OR, active, unrestricted RN licensure from the United States and in the state of hire, OR, active compact multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC), OR Certified Codi. Creates monthly/quarterly reports to present to each line of business providing information on records review, outcomes, trends, and savings that directly impact medical costs and contracting rates.

Paladin Consulting, Inc.

Auditor, Quality Medical

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Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role.

YEAR

CorVel is a leader of risk and healthcare management solutions to employers, third party administrators, insurance companies and government agencies. We are publicly traded (NASDAQ:CRVL) and annual revenues exceeded $493 million in FY2015. Our continued customer growth is a testament to our financial stability and our significant investments in new systems and technologies allows us to continue to deliver industry-leading solutions to the marketplace. CorVel has approximately 3,500 associates who serve more than 2,000 customers through a national branch office network covering all 50 states.

CorVel Corp

Clinical Review Auditor I

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Employees have access to free assistance navigating the Public Service Loan Forgiveness program and submitting their federal student loans for forgiveness. Performance bonus: UCHealth offers a 3-Year Incentive Bonus to recognize employee contributions to our success in quality, patient experience, organizational growth, financial goals and tenure.

University of Colorado Health

Revenue Recovery Auditor

EXL never requires or asks for fees/payments or credit card or bank details during any phase of the recruitment or hiring process and has not authorized any agencies or partners to collect any fee or payment from prospective candidates. EXL harnesses the power of data, analytics, AI, and deep industry knowledge to transform operations for the world's leading corporations in industries including insurance, healthcare, banking and financial services, media and retail, among others.

ExlService Holdings Inc

Quality Analyst IV - Clinical Validation Auditor (CVA), Healthcare

The audit scope includes a) the regulatory and industry research needed for audit planning, b) pre and post audit meetings with stakeholders, c) cohesive audit report that communicates results and includes a corrective action plan if warranted, and d) education and training to stakeholders as needed. Bachelor's degree in a related field and a minimum of 2 years of medical billing, coding, and or audit experience or high school diploma or equivalent (GED) and 4 years of medical billing, coding, and or audit experience required; college degree preferred.

MUSC

Compliance Auditor

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Consults with clinical operations leaders to identify, develop, and respond to training needs and requests Develops curriculum, maintains currency, and revises as appropriate Plan, coordinate, deliver, and evaluate clinical training for clinical operations programs, including: New hire onboarding. Required License Active, current, and unrestricted license to practice in the State of Arizona (or an endorsement to work in Arizona) as a behavioral health professional such as LCSW, LPC, LISAC LMFT, or licensed psychologist (Psy.

Blue Cross Blue Shield of Arizona

Clinical Trainer & Auditor, Utilization Management - Remote AZ

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OTHER

The Contractor shall continuously review and participate in industry changes and updates, specifically but not limited to, ICD-10-CM/OCS ad AMA CPT coding guidelines to look for, and develop ways, to evaluate, improve research strategy, processes, policies, and procedures within the WTC Health Program in accordance with the Research and Evaluation Branch’s and Quality and Evaluation Team’s functions and goals. On July 1, 2011, Centers for Disease Control and Prevention (CDC), National Institute for Occupational Safety and Health (NIOSH), WTC Health Program was established as a federal health care program to provide medical monitoring and treatment for eligible members in accordance with the James Zadroga 9/11 Health and Compensation Act of 2010.

PSI has been a leading provider of IT solutions and services to federal government and private sector organizations since 1988. The company leverages proven management processes to help your organization to run seamlessly. With a highly trained technical staff, PSI applies the industry's most advanced methodologies and broad-based support services to clients in government agencies and the commercial sector. At PSI, we are committed to serve you and your business with the highest standards of quality. We know that it's people — yours and ours — who matter most. PSI's competitive market rates, along with the knowledge and expertise of our personnel and partners, allow us to provide cost effective solutions that unravel your IT challenges — and are the ultimate drivers of our mutual success.

Planned Systems International, Inc.

Claims Auditor, Reviewer and Coder

[AW]-iCims

The audit scope includes a) the regulatory and industry research needed for audit planning, b) pre and post audit meetings with stakeholders, c) cohesive audit report that communicates results and includes a corrective action plan if warranted, and d) education and training to stakeholders as needed. Education requirements: Bachelor"s degree in a related field and a minimum of 2 years of medical billing, coding, and or audit experience or high school diploma or equivalent (GED) and 4 years of medical billing, coding, and or audit experience required; college degree preferred.

Medical University of South Carolina

ADAPTED_NOW

Defend the hospitals revenue through research, documentation and negotiation by participating in and acting as a content expert for the hospital in audits conducted by third parties including, but not limited to, Blue Cross Catastrophic audits; HOPP audits; MPRO audits and all commercial insurance audits. DMC Sinai-Grace Hospital is DMC’s largest hospital, offering a comprehensive heart center, cancer care, gerontology, emergency medicine, obstetrics/gynecology and cosmetic services.

DMC Sinai-Grace Hospital

Clinical Auditor

Tenet Healthcare Monster

Clinical Trainer & Auditor - Remote AZ

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The Charge Code Auditor for the Birthing Center is responsible for ensuring accurate, complete, and timely charge capture for all hospital obstetric services, including OB Emergency Department (OB ED) visits, OB Operating Room procedures, vaginal and cesarean deliveries, newborn hearing screens, and circumcisions. The largest of the four Duke Healthhospitals with 1062 patient beds, it features comprehensive diagnostic and therapeutic facilities, including a regional emergency/trauma center, an endo-surgery center, and more.

Duke University

CHARGE CODE AUDITOR

Charge Code Auditor

Our current reasonable and good faith estimate of the annual salary wage range for this position is approximately $60,000 to $75,000 Premium Auditor I and $80,000 - $88,000 Premium Auditor II based on a variety of factors including, but not limited to, relevant skills and experience, educational background and certifications, performance and qualifications, market demand for the role and other organizational needs. This position contributes to the company’s profitability by completing voluntary audits accurately and timely, and by maintaining a high level of customer service to develop and maintain positive agent and insured relationships.

Arbella

Premium Auditor I/II

Houston Methodist also includes a research institute; a comprehensive residency program; international patient services; freestanding comprehensive care clinics, emergency care and imaging centers; and outpatient facilities. The health system consists of eight hospitals: Houston Methodist Hospital, its flagship academic hospital in the Texas Medical Center, seven community hospitals and one long-term acute care hospital throughout the Greater Houston metropolitan area.

Houston Methodist Hospital

Coding Quality Auditor

Evaluate medical records to ensure the accuracy of clinical documentation to support the acuity of the patient, risk profiles for HCC capture and recapture, and diagnostic and procedural code integrity in compliance with ICD-10-CM and CPT-4/HCPCs rules and guidelines. Complies with all applicable laws, regulations, policies and procedures, supporting the organization's corporate integrity efforts by acting in an ethical and appropriate manner, reporting known or suspected violation of applicable rules, and cooperating fully with all organizational investigations and proceedings.

St. Charles Health System

Ambulatory Services Auditor/CDS 1

The Clinical Documentation Auditor will identify areas of improvement to fully, compliantly, and accurately reflect patient acuity through DRG assignment, severity of illness, risk of mortality and risk adjustment factors via primarily in-depth retrospective (post-discharge, prebill) audit of the patient's clinical record and related findings and queries performed by the Clinical Documentation Specialists. The combined efforts of the organization's outstanding physicians, superb nurses, and dedicated clinical and professional staff have made us one of the most highly respected healthcare organizations in the state, the largest employer in Passaic County, and one of the nation's "100 Best Places to Work in Health Care".

St. Joseph's Healthcare System

Clinical Documentation Auditor

Our more than 25,000 team members and more than 6,000 physicians aim to deliver transformative patient experiences and expert care close to home across more than 300 ambulatory locations and eight acute care hospitals - Edward (Naperville), Elmhurst, Evanston, Glenbrook (Glenview), Highland Park, Northwest Community (Arlington Heights) Skokie and Swedish (Chicago) - all recognized as Magnet hospitals for nursing excellence. Reporting to the Manager of Billing Compliance, this position supports the Corporate Compliance Program by conducting routine audits and investigations related to coding, billing, documentation, and operational quality assurance processes that impact payer reimbursement for medical services.

NorthShore University HealthSystem

Billing Compliance, Senior Auditor

IRecruitee

As one of the nation's largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 137 hospital-based locations, in addition to its home-based services and virtual care offerings. CommonSpirit has more than 157,000 employees, 45,000 nurses and 25,000 physicians and advanced practice providers across 24 states and contributes more than $4.2 billion annually in charity care, community benefits and unreimbursed government programs.

CommonSpirit Health

Revenue Cycle Auditor-Educator Coding

Role: The Corporate Compliance Auditor is responsible for assisting the Director of Compliance/Risk in planning, developing and coordinating the affiliates' quality improvement program and related performance improvement projects as related to a regulatory compliance for admissions and recertification. Collects, reviews, and analyzes data pertaining to audit functions including regulatory outcome measures for the Director of Compliance/Risk to report to the Audit and Compliance Committee.

Nurse Auditor Jobs in the United States

Clinical Documentation Consultant (CDI) DRG Validation / Auditor Pyramid, Inc

Auditor, Quality Medical Paladin Consulting, Inc.

Clinical Review Auditor I CorVel Corp

Revenue Recovery Auditor University of Colorado Health

Quality Analyst IV - Clinical Validation Auditor (CVA), Healthcare ExlService Holdings Inc

Compliance Auditor MUSC

Clinical Trainer & Auditor, Utilization Management - Remote AZ Blue Cross Blue Shield of Arizona

Claims Auditor, Reviewer and Coder Planned Systems International, Inc.

Compliance Auditor Medical University of South Carolina

Clinical Auditor DMC Sinai-Grace Hospital

Clinical Trainer & Auditor - Remote AZ Blue Cross Blue Shield of Arizona

CHARGE CODE AUDITOR Duke University

Charge Code Auditor Duke University

Premium Auditor I/II Arbella

Coding Quality Auditor Houston Methodist Hospital

Ambulatory Services Auditor/CDS 1 St. Charles Health System

Clinical Documentation Auditor St. Joseph's Healthcare System

Billing Compliance, Senior Auditor NorthShore University HealthSystem

Revenue Cycle Auditor-Educator Coding CommonSpirit Health

Per Diem - Corporate Compliance Auditor Chapters Health System Inc

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