Average salary: $97,884 /yearly
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$37.5 - $40 per hour
...responsible for ensuring regulatory compliance related to Utilization Management (UM) and Case Management (CM) activities. The CQM Nurse auditor reports directly to the CQM Manager. CQM nurse duties include, but are not limited to, performing UM process related internal...SuggestedHourly payFull timeCasual workRelocation packageFlexible hoursRegal Medical Group
Canoga Park, CA10 hours ago- Position Overview Assists with the daily coordination of personnel and resources within a clinical specialty or department. Reports to: Director Patient Financial Services FLSA: Exempt Minimum Qualifications Education: Associate's degree required; Graduate of a Program...SuggestedWork experience placement
$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- ...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
- ...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
San Diego, CA2 days ago - ...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...SuggestedHourly payDaily paidRemote work
FlexStaff Careers
Garden City, NY2 days ago - ...Nurse Auditor Portland, OR Exp 5-7 years This position can be located in Tacoma, WA; Seattle, WA; Burlington, WA; Salt Lake City UT; Medford, OR; Portland, OR; Lewiston, ID Candidates must work at least 6 months in the office before telecommute work will be considered...SuggestedWork at officeRemote work
- ...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, CA10 hours 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
Long Beach, CA1 day ago - Compliance Auditor - Nurse (2604178) Description Job Purpose The Compliance Auditor (CA) reports directly to the Vice President of Compliance (VPC) to conduct compliance audits for Health Care Centers (HCC), Hospice, Home Health and/or SOURCE/CCSP service lines. The CA...SuggestedFlexible hoursShift work
$67.1k - $102.46k
...Hybrid Remote Rn-Nurse Auditor For Hcc Program Management Department Presbyterian is seeking a hybrid remote RN-nurse auditor for the Hcc Program Management Department. This role will support the hierarchical condition categories (hcc) processes for pmg and ahwa clinics...SuggestedFull timeRemote workShift work- ...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...Suggested
- 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...Suggested
- A healthcare organization is seeking a Nurse Researcher Assessor/Auditor to work from Frankfort, Kentucky, and telecommute. The ideal candidate will be a registered nurse responsible for conducting waiver audits and ensuring compliance with Medicaid regulations. This position...SuggestedRemote job
$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...SuggestedRemote job- ...follows TMC policy guidelines; communicates directly with payer auditors to determine settlement; records data for trending. Executes... ...Education: Graduation from a qualified, nationally accredited nursing program. Experience: Three (3) years of clinical nursing...
- ...RN Clinical Auditor Responsible for conducting comprehensive review of claim data and/or medical record documentation related to Fraud... ...Qualifications Qualifications Required: Registered Nurse with an active, current, unrestricted license in RI in good standing...Contract workWork at office
$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...Bi-weekly payFull timeTemporary workApprenticeshipRemote workHome officeMonday to Friday- ...A leading health insurance provider is looking for an experienced Delegation Operations Nurse Auditor in Los Angeles, CA. This role focuses on auditing Utilization Management processes, identifying issues, and ensuring compliance with organizational goals. Candidates should...Work at office
Blue Shield of CA
Los Angeles, CA1 day ago - Job Description Department: Patient Fin. Services Shift: Day Working Hours: 8a-5p Summary: Responsible for the auditing of patient bills and medical record documentation to ensure accurate charging based on billing and coding guidelines. Will verify potential...Flexible hoursShift work
Baptist Health
Arkansas4 days ago - ...Summary M-F Days On-site No call, no weekends, no holidays Previous Operating Room RN and EPIC experience is preferred. Bachelors of Nursing required. Masters of Nursing, Masters of Business or Healthcare Administration preferred. Responsibilities include auditing all...
- A leading healthcare provider is seeking a Clinical Quality Assurance Auditor to improve care quality for senior members. You will audit provider documentation, analyze clinical data, and ensure compliance with standards. The ideal candidate should have a bachelor's degree...Full timeWork at office
- A leading company seeks a Registered Nurse HEDIS for a 7+ month assignment in Chattanooga, TN. This role involves the retrieval and review of medical records for quality measures, requiring an active RN license in Tennessee. The ideal candidate should possess excellent...
- ...Detect discrepancies in provider billing and recommend adjustments to ensure proper reimbursement. Qualifications: · Registered Nurse required. ~2+ years with inpatient claims, preferably NICU and maternity required. ~ Inpatient Coding Certification required -...Remote jobTemporary workCasual workWork at office
- ...Description Job Description Position Purpose: 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...Temporary work
$48.56 - $72.85 per hour
...Job Title Reporting to the Nurse Manager, Cath Lab, the Nurse Auditor performs thorough chart review of Electronic Medical Records (EMR) documentation for inaccuracies, omissions, misspellings, and charge review. As needed, facilitates documentation correction with...Full timeLocal area- Overview To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals...Permanent employment
Yale New Haven Health
Westerly, RI3 days ago - ...address and resolve problems that may arise. EEO/AA/Disability/Veteran Responsibilities * * Clinical Care * 1.1 The Certified Registered Nurse Anesthetist (CRNA) implements accurate, safe, patient centric anesthetic care. * * Professional Skill * 2.1 Understands physiologic...Work experience placementImmediate start
Yale New Haven Health
Lincoln, RI1 day ago $60k
...Overview Certified Registered Nurse Anesthetist Specialty: CRNA/Certified Registered Nurse Anesthetist Hospital Site : Northeast Medical Group Location: New London,CT Work Schedule: Day / Evening Scheduled Hours: 40 Position Type: FTE EMR...Work experience placementRelocation packageFlexible hoursNight shiftAfternoon shiftYale New Haven Health
Stonington, CT4 days ago- ...days? notice when transitioning or resigning from the call team. Responsibilities * * Clinical Care * 1.1 The Certified Registered Nurse Anesthetist (CRNA) implements accurate, safe, patient centric anesthetic care. * * Professional Skill * 2.1 Understands physiologic...Full timeWork experience placementImmediate startRelocation packageFlexible hoursShift work
Yale New Haven Health
Wilton, CT2 days ago
