Average salary: $97,631 /yearly
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- RN Nurse Auditor page is loaded## RN Nurse Auditorlocations: Charlestontime type: Full timeposted on: Posted Todayjob requisition id: R-0000047288**Job Description Summary**The RN Nurse Auditor is a key member of the Clinical Appeals team and reports directly to the Clinical...SuggestedShift workRotating shift
$78.4k - $107.8k
Become a part of our caring community and help us put health first The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and coding for services rendered is complete, compliant, and accurate to support optimal reimbursement...SuggestedBi-weekly payFull timeTemporary workApprenticeshipWork at officeRemote workWork from homeHome officeMonday to Friday- ...experience in using billing and claims forms (UB, CMS, and HCFA). Normally to be proficient in the competencies listed above: •Nurse Auditor would have a/an Associate or Bachelor’s Degree in Nursing or related field and 5 years of hospital quality management, coding or...SuggestedWork at officeRemote work
- ...service to our affiliated Universal Health Services hospitals. The Atlantic Region CBO is seeking a dynamic and talented DRG Nurse Auditor with clinical case management experience to be responsible for analyzing clinical claim denials, drafting detailed appeal letters...SuggestedWork at officeLocal area
- ...performing teams, getting results the right way, and fostering continuous learning. Your Knowledge and Experience Bachelor's of Science in Nursing or advanced degree preferred Current, unrestricted California Registered Nurse (RN) license required 5 years of relevant...SuggestedWork at office2 days per week
Blue Shield of CA
Oakland, CA1 day ago - ...RN Nurse Auditor The RN Nurse Auditor is a key member of the Clinical Appeals team and reports directly to the Clinical Appeals Manager. This role is responsible for conducting clinical reviews of payer audit determinations, identifying improper denials, and preparing...SuggestedRotating shift
- ...Employment Opportunity The Revenue Integrity Nurse Auditor is a Registered Nurse (RN) who works in a collaborative environment to plan & provide professional nursing services & standards of practice in accordance with level of experience & education, state board of...SuggestedLocal areaFlexible hours
- ...A leading healthcare company is seeking a Nurse Auditor 2 to perform clinical audits and ensure that medical documentation is compliant and accurate for optimal reimbursement. The role requires an active RN license and a minimum of 2 years of acute inpatient experience...SuggestedRemote work
Humana
Jackson, MS1 day ago $78.4k - $107.8k
...A leading healthcare company is seeking a Nurse Auditor 2 to validate medical documentation for accuracy and compliance. This remote position requires an active RN license and a minimum of 2 years in acute inpatient care. Ideal candidates will have advanced MS Office skills...SuggestedRemote workHumana, Inc.
Nashville, TN1 day ago- ...with regulatory, contractual, and NCQA requirements. Serve as auditor-in-charge for large and complex audits, providing direction and... ...Your Knowledge and Experience ~ Bachelor's of Science in Nursing or advanced degree preferred ~ Current, unrestricted...SuggestedFull timePart timeWork at officeLocal areaWork from homeHome office2 days per week
Blue Shield Of California
Long Beach, CA4 days ago - ...A healthcare organization is seeking a Nurse Auditor 2 to manage clinical audits ensuring accurate medical coding and documentation. This remote position requires an active RN license and at least 2 years of acute inpatient hospital care experience. The Nurse Auditor will...SuggestedRemote work
Humana
Salem, OR1 day ago - ...of the problem and maintains monthly reporting that track and compare patterns of delegated entities. The Delegation Operations Nurse Auditor-LVN-Experienced will report to the Manager of UMDO. In this role you will be assist in maintaining continuous quality improvement...SuggestedWork at office2 days per week
Blue Shield of CA
Redding, CA1 day ago Registered Nurse - Diagnosis Related Group (DRG) Coding Auditor Principal - Carelon Payment Int[...]
$113.77k - $215.57k
Registered Nurse - Diagnosis Related Group Coding Auditor Principal - Carelon Payment Integrity Location: Alternate locations may be considered. This position will work in a hybrid model (remote and office). The ideal candidate will live within 50 miles of one of our Elevance...SuggestedDaily paidWork at officeLocal areaRemote work1 day per week- ...Compliance Auditor Job Purpose: The Compliance Auditor (CA) reports directly to the Vice President of Compliance (VPC) to conduct compliance... ...Certification and Education Requirements: Must be a Registered Nurse in good standing in at least one of the states in which...SuggestedFlexible hoursShift work
- ...Reviewer in Fort Wayne. The ideal candidate will oversee the accuracy and completeness of clinical documentation, perform audits of nursing records, and provide crucial feedback to nursing staff. This role requires an active RN license in Indiana and offers a Monday-...SuggestedWork at officeMonday to Friday
- ...mentioned here, but considered related are not essential functions. Job Qualification 1. Graduate from an accredited School of Nursing. Bachelor's Degree in Nursing, required, or equivalent combination of education and related experience. 2. Current License to...Hourly payDaily paidRemote work
- ...Nursing Support (NS) IV Employment Type: Full time Shift: Day Shift Description: Purpose Work Remote Position (Pay Range: $36.8795-$47.8193) The Nursing Support (NS) colleague (uncertified, certified, unlicensed, or licensed) provides safe, quality health care...Remote jobFull timeLocal areaShift workDay shift
- ...Licensed Nurse Under the direct supervision of the Director of Quality Assurance, the Licensed Nurse is responsible for supporting the compliance functions of the Quality Assurance and Performance Improvement department of JWCH. The responsibilities include: Maintaining...Temporary work
- ...Clinical Nurse Auditor The Clinical Nurse Auditor is responsible for performing comprehensive clinical audits to ensure medical necessity, regulatory compliance, and payer guideline adherence across a broad portfolio of high-complexity claims. This role applies expert...Remote jobWork at officeFlexible hours
$25.01 - $41.25 per hour
A public university in the United States is seeking a Licensed Registered Nurse to perform assessments for elderly and physically disabled individuals. The role includes educating families and professionals on HCB services and requires travel within Boyd County and surrounding...Hourly pay- A leading company seeks a Special Project Nurse/Medical Professional responsible for auditing and reviewing medical records to support quality improvement and HEDIS data collection. The ideal candidate will have RN/LPN credentials with extensive clinical and HEDIS experience...
- ...healthcare organization in Norcross, Georgia, is seeking a Compliance Auditor to conduct internal compliance audits across various healthcare service lines. The ideal candidate must be a Registered Nurse with knowledge of federal regulations and possess strong analytical...
$78.4k - $107.8k
A healthcare services provider is looking for a Nurse Auditor 2 to ensure accurate medical coding and documentation. This remote position involves validating medical records, reviewing claims, and addressing fraud waste concerns. Candidates should hold an RN license, have...Remote job- A leading healthcare provider is seeking a DRG Nurse Auditor in Richmond, Virginia. This role involves analyzing clinical claim denials, drafting detailed appeal letters, and performing DRG validation reviews. Candidates should possess an RN or LPN license, ideally with...
- A health care organization is seeking a Compliance Auditor in Georgia. The position reports to the Vice President of Compliance and involves... ..., Hospice, Home Health, and related services. A Registered Nurse license is required, along with strong analytical and communication...
- RN Clinical Denial Auditor Job Category: Nursing Schedule: Full time Shift: 1 - Day Shift Summary Responsible for reviewing and appealing clinical denials, tracking clinical denial trends, identifying continuous improvement opportunities. Responds to any compliance...Full timeShift workDay shift
- ...RN Clinical Auditor Smithfield, RI - Smithfield, RI 02917 Overview Position Type: Full Time Job Shift: Daytime Education Level:... ...affiliates and/or agents Qualifications Required: Registered Nurse with an active, current, unrestricted license in RI in good...Full timeContract workWork at officeShift work
- ...A leading healthcare organization is seeking a Delegation Operations Nurse Auditor-LVN-Experienced in Oakland, CA. This role focuses on overseeing and improving utilization management audits while ensuring compliance with organizational standards. Ideal candidates will...Work at office2 days per week
Blue Shield of CA
Oakland, CA1 day ago - ...A health insurance provider is seeking a Delegation Operations Nurse Auditor-LVN-Experienced to oversee and audit Utilization Management delegates. This role focuses on organization and reporting of audits, requiring at least 3 years of relevant experience and a current...Work at office
Blue Shield of CA
Long Beach, CA1 day ago - ...A leading healthcare organization is seeking a Delegation Operations Nurse Auditor-LVN-Experienced in Rancho Cordova, CA. This role involves maintaining quality in utilization management audits, ensuring compliance with quality improvement measures. Candidates must hold...Work at office
Blue Shield of CA
Rancho Cordova, CA1 day ago
