RN Medical Review Auditor - CMS RAC
$81k - $90kPerformant Corp
Performant Corp is seeking a Medical Review Nurse in the Town of Florida, NY. This role involves auditing medical claims for appropriateness, documenting findings, and collaborating with teams to enhance payment processes. The ideal candidate must possess an active RN license and have at least five years of nursing experience in varied settings. This position offers a salary range of $81,000 - $90,000 and includes a comprehensive benefits package such as medical, dental, and 401(k). #J-18808-Ljbffr Performant Corp
Vacancy posted 13 hours ago
Similar jobs that could be interesting for youBased on the RN Medical Review Auditor - CMS RAC in Florida, NY vacancy
$80k - $90k
...Key Responsibilities*** Performs clinical reviews on medical records to maintain subject matter... ...documentation requirements and an understanding CMS, Medicaid and/or Commercial insurance... ...Qualifications*** Active unrestricted RN license #J-18808-Ljbffr Performant CorpCmsMedicalRemote workFlexible hours$81k - $90k
...Responsibilities:*** Auditing claims for medically appropriate services provided... ...applying appropriate medical review guidelines, policies and rules... ...:*** Active unrestricted RN license in good standing, is... ...**Medical Review Nurse - CMS RAC (Government #J-18808-Ljbffr Performant...CmsMedicalFor contractorsWork at officeRemote workWork from homeHome officeShift work- ...Provider Audit and Reimbursement Auditor (PARD) position can fill two primary roles -- desk review/audit, and interim rate review.... ...perform hospital audits. Benefits Medical, dental, vision, life and... ...for Medicare & Medicaid Services (CMS) may require applicants to have...CmsMedicalPermanent employmentTemporary workInterim roleWork at officeImmediate startRemote work
- ...company located in New York is looking for a Clinical Auditor to perform clinical reviews and audits on medical records, ensuring compliance with company policies... ...assurance guidelines. This role requires an active RN license and the ability to analyze claims data and regulations...MedicalRemote job
- RN - Hialeah Urgent Care Center (Full Time, Days) - 301442 Job Summary... ...patient to be seen by the medical team including vital signs, weight... ...with patients and families to review plan of care and solicits input... ...and requirements of the DNV, CMS, DOH, & ACHA. Provides continuous...CmsMedicalFull time
$32.76 - $57.47 per hour
...in multi-disciplinary rounds to review changes in patient status,... ...discharge planning. Reviews the medical record, including medications,... ...discharge (Required) Knowledge of CMS Conditions of Participation for... ...Certifications: Registered Nurse (RN) (Required) Certified Case...CmsMedicalWork experience placementReliefLocal areaFlexible hoursShift work- ...Patient Satisfaction, Jupiter Medical Center is the leading destination... ...Medicare & Medicaid Services (CMS). Education Graduate of an... ...experience required. Current RN licensure in the state of... ...technical developments). I have reviewed these job requirements and verify...CmsMedicalFull timeNight shift
$32.76 - $57.47 per hour
Benefits Medical, Dental, Vision Insurance, Life Insurance, Disability... ...multi-disciplinary rounds to review changes in patient status, progression... ...at discharge Knowledge of CMS Conditions of Participation for... ...Registered Nurse (RN) Certified Case Manager (CCM)...CmsMedicalFull timeWork experience placementLocal areaMonday to FridayFlexible hoursWeekend workDay shift$83.1k - $120.36k
The Clinical Peer Reviewer (Phyiscal Therapy) Utilization Management (UM) plays a critical role in consulting on medical necessity in the context of utilization management and ensuring... ...internal turnaround timeframes and meet CMS, NYS DOH, and Healthfirst standards. As...CmsMedicalWork experience placement- ...Summary We are seeking a detail‑oriented Medical Chart Scrubber to support our clinical and... ...integrity teams. This role focuses on reviewing patient charts for accuracy, completeness... ...standards Familiarity with ICD‑10, CPT, and CMS documentation requirements Experience...CmsMedicalFull timeWork at office
- RN Case Manager - Per Diem page is loaded## RN Case Manager - Per... ...Patient Satisfaction, Jupiter Medical Center is the leading destination... ...Medicare & Medicaid Services (CMS).Education: Graduate of an accredited... ...and completes utilization review activities to ensure compliance...CmsMedicalDaily paidFlexible hours
$32.76 - $57.47 per hour
...family: Benefits from Day One: Medical, Dental, Vision Insurance, Life... ...multi‑disciplinary rounds to review changes in patient status, progression... ...[Required] Knowledge of CMS Conditions of Participation for... ...Certifications: Registered Nurse (RN) [Required] Basic Life Support...CmsMedicalPart timeWork experience placementLocal areaFlexible hoursShift workWeekend work$72k - $81k
Overview Case Manager (Specialty) / RN job at MedWatch. Lake Mary, FL. Scope The Case Manager manages an individual... ...includes, but is not limited to, authorization of services, review of treatment plans for medical necessity, standards of care, and ongoing communication...CmsMedicalTemporary workWork at officeRemote workWork from homeHome office- ...engagement and retentionParticipates in the review of policies and procedures to ensure... ...EXPERIENCE REQUIREDRN Nursing Degree. Unencumbered RN License in the state of employment or... ...of your role:Private Health Care Plans: (Medical, Dental, Vision and Health Savings Account...CmsMedicalTemporary workReliefWork at officeLocal areaMonday to Friday
$140k - $145k
...corporate and external regulatory guidelines. Reviews new regulatory directives and implements... ...package that includes competitive pay, medical, dental, vision, life, and disability... ...requirements under federal programs, including CMS, Medicare, and Medicaid regulations, as...CmsMedicalFull timeTemporary workInterim roleLocal areaWeekend workAfternoon shift- Pinnacle Home Care in Florida is seeking an experienced Clinical Review Specialist to join our team. You will review incoming home health orders for clinical appropriateness, ensure compliance with CMS guidelines, and support patients during intake conversations. The ideal...CmsRemote job
$26.41 - $51.49 per hour
...Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical... ...relevant education and experience. Registered Nurse (RN). License must be active and unrestricted in...MedicalHourly payWork experience placementWork at officeRemote workMolina Healthcare
Florida, NY1 day ago- Clinical Appeals Nurse (RN) Status: Exempt Location: Remote Department... ...HBiz’s revenue cycle operations by reviewing denied claims for clinical accuracy and medical necessity, developing evidence-... ...clinical appeals Familiarity with CMS guidelines, InterQual, Milliman, or...CmsMedicalRemote work
- RN Nursing Supervisor-Nursing Administration-Full Time page is loaded## RN Nursing Supervisor... ...Quality and Patient Satisfaction, Jupiter Medical Center is the leading destination for... ...Centers for Medicare & Medicaid Services (CMS).**Education*** Graduate of an accredited...CmsMedicalFull timeShift work
$62.7k - $100.4k
A healthcare organization is seeking a Clinical Care Reviewer II responsible for processing medical necessity reviews and assisting with care coordination activities. Candidates need to hold an Associate's degree in nursing and have at least three years of clinical experience...Medical- RN - Cardiac Cath Lab Full Time page is loaded## RN - Cardiac Cath Lab Full Timelocations... ...Quality and Patient Satisfaction, Jupiter Medical Center is the leading destination for... ...Centers for Medicare & Medicaid Services (CMS).**Education*** Graduate of an accredited...CmsMedicalFull time
- ...Title: Registered Nurse - Claims & Appeals Review Location: Remote (Anywhere in Florida)... ...facing reviews. Ensure compliance with NCQA, CMS, and state regulations. Qualifications Education... ...platforms Licensure/Certification Valid RN, LPN, or LVN license in applicable state (...CmsContract workRemote workDay shift
- ...Responsibilities of Registered Nurse Concurrent Review; Telephonically review inpatient... ...admissions to assure appropriate level of care and medical necessity Review admissions through... ...Nurse Concurrent Review; Current, active RN in the state of Florida 2+ years of clinical...MedicalWork at officeMonday to Friday
$10k
RN-Telemetry-FT-Nights-Eligible $10K Retention Bonus page is loaded## RN-Telemetry-FT-Nights... ...Quality and Patient Satisfaction, Jupiter Medical Center is the leading destination for... ...Centers for Medicare & Medicaid Services (CMS).Education: Graduate of an accredited school...CmsMedicalFlexible hoursNight shift- ...Nurse position that will ensure the primary, medical care service coordination for dependent... ...Assist Children’s Medical Services (CMS) caregivers in obtaining Durable Medical... ...follow-up appointments and ordered services Reviews the health and wellness reports, Florida...CmsMedical
$206.61k - $413.21k
...and your family: Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance... ...provided. Participate in interdisciplinary case reviews and CDI meetings to drive process... ...documentation aligns with coding guidelines, CMS regulations, and hospital policies....CmsMedicalFull timeLocal areaShift work$85.53k - $159.09k
...you and your family Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance,... ...of core Care Management principles and CMS Conditions of Participation [Required] Knowledge... ...And Certifications Registered Nurse (RN) [Required] Accredited Case Manager (ACM)...CmsMedicalFull timeWork experience placementLocal areaShift work$73.86k - $96.02k
...program that can help employees eliminate their medical plan deductible , reducing out-of-pocket... ...initial, concurrent, retrospective chart review for clinical financial resource... ...continue their non-leadership role as an RN. However, they are required to complete the...MedicalLocal area- ...Psychiatric APRN) provides psychiatric evaluation, medication management, and ongoing treatment... ...state and federal regulations, HRSA, CMS, grant compliance requirements and FoundCare... ...Planning & Documentation Develop, review, and update individualized psychiatric treatment...CmsMedicalWork at office
- ...Patient Satisfaction, Jupiter Medical Center is the leading destination... ...Medicare & Medicaid Services (CMS).Schedule: 40 hours a week, 5... .../ Qualifications*** RN License in the state of Florida... ...circumstances change. I have reviewed these job requirements and verify...CmsMedicalFull timeFlexible hours
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to RN Medical Review Auditor - CMS RAC. Be the first to apply!
Related searches
- neuro icu registered nurse Florida, NY
- new grad rn Florida, NY
- nicu rn Florida, NY
- registered nurse nursing home Florida, NY
- new grad rn residency Florida, NY
- rn observation unit Florida, NY
- rn hospice Florida, NY
- outpatient registered nurse Florida, NY
- rn evening shift Florida, NY
- home health rn case manager Florida, NY