Average salary: $97,631 /yearly
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- ...best for employees. Learn more about why we are one of the Best Companies to Work for in Texas®. The Revenue Integrity Clinical Nurse Auditor leverages clinical knowledge and documentation review to ensure appropriate charge capture and revenue optimization....SuggestedLocal area
UMC Health System
Lubbock, TX1 day ago - ...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
- ...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
$84k - $100k
...: $84,000 - $100,000 (based on experience) The Medical Review Nurse II - SNF/MDS primarily performs medical claims audit reviews. As a MR Nurse, you will join a team of experienced medical auditors and coders performing retrospective and prepayment audits on claims...SuggestedFor contractorsWork at officeRemote workWork from homeHome officeShift workPerformant
United States2 days ago- ...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
Long Beach, CA11 hours 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, CA3 days ago - ...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, MS11 hours 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, TN11 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 California
Long Beach, CA8 days ago $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 workHumana
Atlanta, GA11 hours ago- ...locations and virtual (telemedicine) technology. Harris Health is among an elite list of health systems in the U.S. achieving Magnet® nursing excellence designation for its hospitals, the prestigious National Committee for Quality Assurance designation for its patient-...SuggestedWork experience placementWork at office
Harris Health System
Houston, TX1 day 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
- ...Motor Vehicle Accidents, and Out‑of‑State Medicaid claims as well as denials for all payer classes. Position Summary The Clinical Nurse Auditor is responsible for performing comprehensive clinical audits to ensure medical necessity, regulatory compliance, and payer...SuggestedRemote jobWork at office
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 - 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
$72 per hour
...Temp - Registered Nurse (RN) - Compliance Auditor (Days) Dallas, TX Candidates living within 60 miles of the facility will have a local rate of $72. The Compliance Nurse Auditor is responsible for conducting audits to ensure the clinical documentation contained within...Temporary workLocal area- 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 leading staffing and IT company in California is seeking a qualified candidate for a hybrid role requiring an active LVN or RN license. The position involves auditing denied claims, reviewing processes according to UM guidelines, and collaborating with teams to resolve...
- ...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...
$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 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...
- 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...
$48.77 - $81.51 per hour
...Description Under direct supervision of the Manager, RN Auditor, the RN Auditor is responsible for the review of medical record... ...experience. License / Certification Requirements Registered Nurse LicenseANCC Certification within a year of hire Compensation...Work at officeTorrance Memorial Medical Center
Torrance, CA1 day ago- 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
$81.85k - $155.09k
...-12 Position Title: Diagnosis Related Group Clinical Validation Auditor-RN (CDI, MS-DRG, AP-DRG and APR-DRG) Job Description: Diagnosis... ...Requirements: Requires current, active, unrestricted Registered Nurse license in applicable state(s). Requires a minimum of 10 years of...Full timeTemporary workWork experience placementLocal area1 day per week$90k - $104.84k
...RN, Clinical Auditor - DRG Auditor Remote | Full-Time | Healthcare | Clinical Documentation & Coding About the Role We... ...Required Qualifications Licensure ~ Active Registered Nurse (RN) license required ~(Non-RN candidates will not be considered...Full timeWork at officeRemote workPivotal Placement Services, Inc
Columbus, OH1 day ago$80k - $90k
**ABOUT MACHINIFY:**In October 2025, Machinify acquired Performant and we are now part of the Machinify organization. Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency...Remote workFlexible hours- A healthcare organization in Texas is seeking a Charge Auditor Clinical who is a Registered Nurse. This role is vital for coordinating observation charges and ensuring compliance with billing standards. Responsibilities include reviewing surgical records, educating clinical...Full time
- A leading health company in Colorado is seeking a Diagnosis Related Group Clinical Validation Auditor-RN. The role involves auditing inpatient medical records, ensuring compliance with billing documentation, and utilizing advanced coding expertise. Candidates must hold...Remote jobFlexible hours
- A prominent staffing organization is seeking a Nurse Auditor to conduct post-payment claims audits across multiple locations, including Portland. The ideal candidate will have extensive clinical expertise and qualifications, including an RN license and experience in skilled...
