Remote RN Clinical Auditor - Medicaid Billing Compliance
RADcube
- Remote job
RADcube is seeking a detail-oriented Registered Nurse Clinical Auditor to support medical record reviews and billing compliance audits for Indiana Health Coverage Programs. This remote role requires evaluating provider compliance, preparing audit documentation, and conducting reviews in alignment with healthcare guidelines. Applicants should preferably hold an RN license, coding certification, and have at least one year of experience in Medicaid claims review. Strong analytical and problem-solving skills are essential. The position offers occasional travel within Indiana. #J-18808-Ljbffr RADcube
$80k - $90k
...Responsibilities*** Performs clinical reviews on medical... ...and other compliance and policy/... ...understanding CMS, Medicaid and/or Commercial... ...relates to medical billing.* Demonstrated ability... ...independently in remote setting with minimum... ...unrestricted RN license #J-18808-Ljbffr...Remote workFlexible hours$29 - $52 per hour
...This position is remote in... ...for performing compliance reviews of medical... ...applicable, the Auditor will support appeal... ...Nurse licensure (RN or LPN) with a... ...documentation in a clinical or... ...and healthcare billing practices Experience... ...Familiarity with Medicaid program and/or...Remote workHourly payMinimum wageFull timeContract workWork experience placementLive inLocal areaMonday to FridayShift work- ...is seeking a Diagnosis Related Group Clinical Validation Auditor-RN. The role involves auditing inpatient medical records, ensuring compliance with billing documentation, and utilizing... ...competitive salary and benefits with flexible remote work options. #J-18808-Ljbffr...Remote jobFlexible hours
$82.23k - $155.81k
Elevance Health seeks a Diagnosis Related Group Clinical Validation Auditor-RN to conduct audits on inpatient medical records, ensuring documentation accuracy and compliance. This remote role requires a current Registered Nurse license and extensive experience in claims...Remote job$34.23 - $61.15 per hour
...Clinical DRG RN Auditor $10,000 SIGN ON BONUS FOR EXTERNAL APPLICANTS Optum... ..., and discharge statuses billed by hospitals to identify overpayments... ...knowledge of and compliance with changes and updates to... ...to work independently in a remote environment and deliver exceptional...Remote workHourly payMinimum wageFull timeTemporary workWork experience placementWork at officeLocal areaRelocation package$38.92 - $60.33 per hour
...Wisconsin (Froedtert Hospital). Remote work is possible for this... .... Job Summary The RN Diagnosis-Related Group (DRG) Auditor conducts targeted and random... .... The auditor ensures compliance with documentation standards... ...5 years of experience in Clinical Documentation Integrity...Remote workHourly payTemporary work- ...Description This is a remote position. Registered Nurse Clinical Auditor We are seeking a detail... ...medical record reviews, billing compliance audits for the Indiana... ...national healthcare and Medicaid guidelines. Stay current... ...Qualifications RN license preferred; Indiana...Remote workContract work
- ...and conduct medical billing audits for the... ...documentation for 18 clinical departments under... ...direction of the Compliance Officer. Provide training... ...is currently remote (work from home,... ...auditing, Medicare and Medicaid, or related... ...PFS and University Auditor as needed. Conduct...Remote workWork from home
$68k - $120.5k
...Medical Billing Auditor Working at Yale means contributing... ...documentation for 18 clinical departments under the direction of the Compliance Officer. Provide training... ...is currently remote (work from home, in or... ...auditing, Medicare and Medicaid, or related clinical field...Remote workFull timeWork at officeWork from home- ...Job Title: Clinical Nurse Auditor – Payment Integrity Job Summary... ...reviews to ensure accurate billing, compliance with payer regulations, and... ...requires a Registered Nurse (RN) with coding... ...insurance plans, Medicare, and Medicaid programs is essential....Remote workFull timeWork at office
- ...Compliance Risk Auditor UI Health Care's Joint Office for Compliance... ...Health Care's coding/billing and documentation... ...email to providers, clinical department administrators... ...for Medicare, Medicaid, and other federal payer... ...must comply with the remote work program and related...Remote workWork at office
- ...Billing Compliance, Senior Auditor Reporting to the Manager of Billing Compliance,... ...partnership with administrative and clinical leadership. Position... ...Hybrid (Evanston, IL and remote) Full Time/Part Time:... ...guidelines, and Medicare/Medicaid standards (e.g., NCDs,...Remote workFull timeContract workPart timeMonday to Friday
- ...Job Title NC - RN Clinical Research Coordinator - Asheville Address Asheville... ...consent discussions in compliance with SOPs. Maintain accurate... ...ensure compliance with research billing practices. Critical... ...to Friday 8:00 AM - 5:00 PM. Remote work possible as required. Education...Remote workFull timeMonday to Friday
$68.57k - $104.84k
...Clinical Review QC Auditor CERIS in Fort Worth, TX is seeking a DRG... ...rules. This is a remote position. Essential... ...accuracy of billing through verification... ...including Medicare and Medicaid Understand and comply... ...Experience: LVN or RN license in the state...Remote workMinimum wageFull timeWork at officeLocal areaFlexible hours- RN Inpatient Hospital Auditor - Remote (New Jersey) - 6‑month contract, 3+ years experience... ...of Centers of Medicare & Medicaid Prospective Payment... ...site audits of hospital billing and coding practices and... ...with new innovations in clinical data review and company cost...Remote jobWeekly payDaily paidContract workLocal areaImmediate start
$96.46k - $144.69k
Overview Clinical Revenue Auditor-CDM Patient Financial Services... ...-Option to work remote or hybrid. The... ...health and compliance of the organization... ...care and medical billing and reimbursement... ...for Medicare and Medicaid Services (CMS). Mitigate... ...Nurse (RN), Occupational Therapist...Remote workFull timeTraineeshipLocal area$62.35k - $65k
...Clinical Audit Specialist We are Hiring! Location: REMOTE (some on-site for meetings required) Department: Quality & Compliance Employment Type: Full-Time Schedule... ...standards and billing and documentation standards... ...regulations and Medicaid Managed Care...Remote workFull timeLocal area- ...medical records to ensure clinical documentation supports... ..., and accurate billing practices. Identify... ..., coding, billing, and compliance discrepancies and develop... ...risks related to Medicare, Medicaid, and other federal healthcare... ...and unrestricted Texas RN License or Compact RN...Work at office
- ...Description Summary: The Charge Auditor Clinical is a Registered Nurse who... ...oversees the documentation and billing of the observation patients to ensure compliance with all standards and guidelines... ...Registrations, or Certifications Active RN Licensure in the State of...Full time
- ...Health is looking for an RN Diagnosis-Related Group (DRG) Auditor in Milwaukee, Wisconsin.... ...medical records to ensure compliance with standards and accurate... ...a minimum of 5 years in Clinical Documentation Integrity,... ...offers the possibility of remote work and a comprehensive...Remote work
$56.17k - $70.22k
...Medical Coding Auditor UNM Medical Group, Inc. is hiring... ...Auditor to join our Compliance Team. This opportunity is a remote, full-time, day shift opening... ...of UNM Medical group billing systems procedures to... ..., medical diagnoses and clinical procedures ensuring that...Remote workPermanent employmentFull timeFor contractorsLive inWork from homeRelocationRelocation packageDay shift- ...support for healthcare services clinical auditing activities. Performs... ...- ensuring quality compliance and desired member outcomes.... ...Assurance, Centers for Medicare and Medicaid Services (CMS), and state/federal... .... • Registered Nurse (RN). License must be active and...Remote workContract workWork at office
$87k
...: The Nurse Auditor will have full... ...ensure that the clinical documentation contained... ...the patient's bill, and to ensure... ...for effective remote work.... ...for Medicare & Medicaid Recovery Audit... ...accuracy and billing compliance as support for... ...Certification: RN License (...Remote workFull timeFor contractorsRelocationMonday to FridayFlexible hours$122 per hour
...Licensed Clinical Social Worker (LCSW) Up to $122/hour Fully Remote or In-Person Flexible Schedule... ...checks, and automated billing, reducing admin time.... ...automated billing. Full Compliance: Stay protected with... ...Advantage and Medicaid. Provider Benefits...Remote workBi-weekly payHourly payExtra incomeFull timePart timePrivate practiceFlexible hours- ...Clinical Coding Specialist At Memorial Hermann, we pursue a common goal of delivering... ...position typically reports to the Coding Compliance Manager. Minimum Qualifications Education... ...to documentation, coding, and billing. Knowledge of database applications and...Remote work
- ...Waste, and Abuse (FWA) Auditor serves a crucial role... ..., waste and abuse for Medicaid programs. A major function... ...types to ensure compliance with federal and state... ...leads and detect aberrant billing practices, including... ...aspects of the job are remote. Responsibilities...Remote workWork at office
- ...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 and quality... ...guidelines. This role requires an active RN license and the ability to analyze claims...Remote work
$67.3k - $93.05k
...Acentra Health, LLC is seeking a Clinical Assessor for a hybrid role, operating primarily... ...candidate will hold a valid NC or Compact RN license and have a minimum of two years of... ...Responsibilities include conducting assessments for Medicaid programs and ensuring beneficiaries...Remote work$50k - $55k
...Medical Claims Auditor (Remote - Texas) Great companies need great teams... ...claims to ensure accuracy, compliance, and adherence to company... ...solid understanding of medical billing and coding, and experience... ...regulatory guidelines (CMS, Medicaid, Medicare, and payer contracts...Remote workFull timeMonday to FridayFlexible hours- ...Acentra Health is seeking a RN Clinical Assessor in Morgantown, West... ...eligibility assessments for Medicaid recipients. This hybrid role involves local travel and remote work, requiring an established... ...managing assessments, ensuring compliance with protocols, and maintaining...Remote workLocal area
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