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FEED

They are responsible for submitting data to CMS, reviewing and classifying safety events, performing staff interviews, and participating on safety improvement teams. Sacred Trust, Personal Reverence, Thoughtful Anticipation, Team Accountability and Creative Vitality ask more of us than merely completing some list of tasks.

San Juan Regional Medical Center

Clinical Auditor II

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Jupiter Medical Center is the only hospital in Palm Beach, Martin, St. Lucie and Indian River counties to receive a 4-star quality and safety rating from the Centers for Medicare & Medicaid Services (CMS). Maintain current knowledge base of governmental and regulatory requirements and provide education to management and governance as needed concerning organizational risks and their potential impact.

Jupiter Medical Center

Healthcare Internal Auditor

Qualifications: Education Required: Bachelor''s degree in nursing or an equivalent combination of education, training, and experience is required OR Licensed Clinical Social Worker, Licensed Marriage Family Therapist or Licensed Mental Health Counselor. The Clinical Auditor I is a liaison and resource between WellSense Health Plan and external providers, working collaboratively with a diverse group, including management, physicians, clinical and non-clinical personnel.

YEAR

Well Sense Health Plan Inc

Clinical Auditor I

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PACS business support division, PACS Services, provides technology and administrative support services — accounting, finance, human resources, compliance, payroll, AR/AP, legal, risk management, information technology, corporate communication, and other business advice and support — to their healthcare facilities, reducing administrative burdens so their leadership and care teams can focus on the care, well-being, and quality of life of their patients and residents. Reporting to the Senior Director of Clinical Compliance Investigations, the Clinical Compliance Auditor I is responsible for conducting routine audits of clinical documentation, regulatory compliance practices, and reimbursement related processes related to Skilled Nursing Facilities.

PACS Group

Clinical Compliance Auditor I - PDPM

HOUR

US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. Job Description: This position is responsible for conducting quality audits for state audits, HEDIS and quality referral and complaints issues.

US Tech Solutions, Inc.

HEDIS Quality Auditor # 26-21590

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Location: Primarily remote with biannual travel to New York required, applicant outside of New York can also apply for this role, as long as they are open to NYC few times in year. Position Purpose: Develop and conduct training and quality auditing programs for Diagnosis Related Group (DRG) and Medical Record Audit programs.

Macpower Digital Assets Edge Private Limited

Clinical Coding Auditor & Trainer (Associate & Senior Level)

tracking of internal audit results for all of PHS; enterprise-wide training of all PHS coding, audit, physician and clinician personnel; support via auditing and training the enterprise-wide corrective action plans for coding, audit, physician and clinician personnel identified as low performers; insure the accuracy of defensive and proactive audits of medical records with billing and identifies and recommends actions related to discrepancies; responds and conducts medical record reviews requested by external regulatory agencies such as JCAHO, CMS and NMMRA as well as insurance companies such as PHP. Summary: With minimal supervision directly supports the following responsibilities of the Coding and documentation quality assurance (CDQA) team: implementation of and compliance to enterprise-wide and department coding policies and procedures for PHS; compliance to all external regulatory agency coding rules and regulations; Demonstrates high-level of proficiency in performing and/or managing internal audits or reviews to assess compliance/quality monitoring performed by PHS departments while serving as a resource on documentation, billing, and clinical coding compliance questions.

Presbyterian Healthcare Services

Remote CPMA Educator & Auditor

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.

Advanced Technologies and Laboratories International Inc

Claims Auditor, Reviewer and Coder

Performs internal audits of hospital accounts; processes routine insurance audits; audits accounts as requested by patients; performs audits of accounts to separate medical charges from elective cosmetic surgery procedures; manual charge entry/credit for Pharmacy discrepancies; charge correction and billing requirements for Medical Oncology accounts, provide written appeals for RAC and non-RAC denials. Experience:Minimum of 3 years experience in hospital clinical setting, Patient Accounting, Chargemaster, coding, compliance or related field.

Huntsville Hospital

Auditor RI

Minimum 2 years working in an acute care setting as a Clinical Documentation Specialist (CDS) Required and Minimum 5 years healthcare experience Required and Prior experience of working as a CDI/Coding auditor is preferred Preferred and Prior experience of working in inpatient case management or utilization review is preferred Preferred and Required Minimum Skills: a) Initiates audits and prepares findings to assist CDI Education Lead in preparing and providing regular CDI education to stakeholders based on findings, trends, industry events and based on management needs b) Audits medical records to determine opportunities as they relate to clinical documentation improvement, PSI, HACs, mortality, etc.

Wellstar

Clinical Documentation Auditor

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Atlantic Medical Group, comprised of 1,000 physicians and advanced practice providers, represents one of the largest multi-specialty practices in New Jersey and includes finance, legal, marketing, human resources, talent acquisition, ISS and more. Atlantic Health scored four “A” grades by The Leapfrog Group in its Fall 2025 Hospital Safety Grades, performance measures reflecting errors, accidents, injuries and injections, as well as systems hospitals have in place to prevent harm.

Atlantic Health System

Financial Internal Auditor II

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

Itemized Bill Review Auditor III (IBR)

Our client is seeking an experienced Coding Auditor/Educator to ensure coding accuracy, regulatory compliance, and ongoing clinician education. The ideal candidate combines strong outpatient coding and auditing expertise with a proactive, confident approach to compliance and education.

J. Morrissey

Medical Auditor

HaleyMarketing

Preferred skills, qualifications and experiences: One or more of the following certifications are preferred: Certified Clinical Documentation Specialist (CCDS), Certified Documentation Improvement Practitioner (CDIP), Certified Professional Coder (CPC) or Inpatient Coding Credential such as CCS or CIC. Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum of 5 years of experience working with ICD-9/10CM, MS-DRG, AP-DRG and APR-DRG; or any combination of education and experience, which would provide an equivalent background.

Elevance Health

Patient Safety DRG Clinical Validation Auditor

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The Code-Based Reimbursement Auditor performs audits of Charge Master driven and HIM assigned codes and medical record documentation against the itemized charges and facility assigned on government and non-government accounts and adjusts them for incorrect items and/or services; Assists with billing edit resolution and provides coverage guildelines for billable services. Daily and/or weekly websites are reviewed to include the Federal Register, Medicare and Fiscal Intermediary transmittals, bulletins, and memorandums, including NCD, LCD/LMRP, OCE, and CCI edit management, payment reconciliation, and financial impact analysis.

FMOL Health

Code Based Reimbursement Auditor

One or more of the following certifications are preferred: Certified Clinical Documentation Specialist (CCDS), Certified Documentation Improvement Practitioner (CDIP), Certified Professional Coder (CPC) or Inpatient Coding Credential such as CCS or CIC. Identifies potential documentation and coding errors by recognizing aberrant coding and documentation patterns such as inappropriate billing for readmissions, inpatient admission status, and Hospital-Acquired Conditions (HACs).

Diagnosis Related Group Clinical Validation Auditor

Candidates must hold at least one active clinical license or certification in good standing Nursing: RN, BSN, LPN, LVN, Imaging/Radiology: ARRT (R), ARRT, CT, MR, VI/CI, ARDMS- Respiratory Therapy: RRT, CRT- Laboratory: MLS(ASCP), MT(ASCP), MLT(ASCP)- Therapies: PT/DPT, PTA; OT, COTA; CCC-SL, Knowledge of healthcare billing and practices, coding systems (ICD-10, CPT), and payor regulations. The Revenue Integrity Clinical Charge Auditor is responsible for reviewing and auditing clinical documentation and charge capture processes to ensure accurate billing and reimbursement for healthcare services.

Penn Highlands Healthcare

Clinical Charge Auditor Revenue Integrity DuBois CRC

The RN Charge Auditor will execute clinical charge audits of medical records on behalf of Intermountain hospitals and clinics for denials review, defense audits, disallowed charges, and retrospective reviews, and will serve as clinical resource for all Intermountain Health Revenue Cycle departments. However, we are currently not considering candidates who reside or plan to reside in the following states: California, Connecticut, Hawaii, Illinois, Massachusetts, Maine, Minnesota, New York, Pennsylvania, Rhode Island, Virginia Vermont, Washington.

Intermountain Health Inc

Revenue Integrity Charge Auditor

Anchored in the state's historic capital city, Albany Medical Center offers a full range of inpatient and outpatient careand is home to the region's largest hospital, only Level 1 adult and pediatric trauma centers, and only children's hospital. The successful candidate will plan, coordinate and manage project activities to ensure goals and objectives are accomplished within prescribed timeframes and budget parameters and that results are proactively communicated to business stakeholders.

Albany Medical Center

Rev Cycle Internal Auditor

IRecruitee

Experience (required): 5 to 7+ years of working with ICD-9/10CM, MS-DRG, AP-DRG and APR-DRG with a broad knowledge of medical claims billing/payment systems provider billing guidelines, payer reimbursement policies, medical necessity criteria and coding terminology. This position is responsible for auditing inpatient claims and documenting the results of those audits, with a focus on clinical review, coding accuracy, and the appropriateness of treatment setting and services delivered.

Nurse Auditor Jobs in the United States

Clinical Auditor II San Juan Regional Medical Center

Healthcare Internal Auditor Jupiter Medical Center

Clinical Auditor I Well Sense Health Plan Inc

Clinical Compliance Auditor I - PDPM PACS Group

HEDIS Quality Auditor # 26-21590 US Tech Solutions, Inc.

Clinical Coding Auditor & Trainer (Associate & Senior Level) Macpower Digital Assets Edge Private Limited

Remote CPMA Educator & Auditor Presbyterian Healthcare Services

Claims Auditor, Reviewer and Coder Advanced Technologies and Laboratories International Inc

Auditor RI Huntsville Hospital

Clinical Documentation Auditor Wellstar

Financial Internal Auditor II Atlantic Health System

Itemized Bill Review Auditor III (IBR) ExlService Holdings Inc

Medical Auditor J. Morrissey

Patient Safety DRG Clinical Validation Auditor Elevance Health

Code Based Reimbursement Auditor FMOL Health

Diagnosis Related Group Clinical Validation Auditor Elevance Health

Clinical Charge Auditor Revenue Integrity DuBois CRC Penn Highlands Healthcare

Revenue Integrity Charge Auditor Intermountain Health Inc

Rev Cycle Internal Auditor Albany Medical Center

Auditor Clinical Validation DRG Cotiviti Holdings Inc. (Inactive)

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