Average salary: $97,631 /yearly
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$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
Long Beach, CA3 days ago $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 States18 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, TN3 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, OR3 days 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, CA1 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 California
Long Beach, CA6 days ago - 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...Suggested
TEKsystems
Los Angeles, CA3 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, GA3 days 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
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- ...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
$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- ...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...
- 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...
- 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...
$35 - $50 per hour
A healthcare staffing agency is seeking a candidate for a hybrid role in Utilization Management based in Canoga Park, CA. The ideal applicant must possess an active LVN or RN license and have at least 2 years of experience in managing HMO/Medicare claims. Responsibilities...TEKsystems
Los Angeles, CA14 hours agonew- 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
- A healthcare technology company is seeking a Quality Assurance RN to audit clinical documentation for compliance and accuracy in a flexible remote role. The ideal candidate will have an active RN license and relevant QA experience in home health. This position offers competitive...Remote workFlexible hoursShift workWeekend work
Tandem
Mission, KS3 days ago - ...A leading health insurance provider is seeking a Delegation Operations Nurse Auditor in Redding, California. This role involves organizing, tracking, and reporting on IPA Utilization Management audits. The ideal candidate holds a current CA LVN license and has extensive...Work at office2 days per week
Blue Shield of CA
Redding, CA14 hours agonew - ...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, CA3 days ago - ...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, CA2 days ago - ...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, CA3 days ago - ...delivering top-quality talent in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy, and Nursing. Job Description This position is for the 2018 HEDIS audit. The role involves performing medical record reviews and data extraction...Work at officeRemote workWork from home
Integrated Resources
Newark, NJ4 days 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, CA3 days ago - ...A leading health insurance provider in California is seeking a Delegation Operations Nurse Auditor. In this role, you will manage asset audits, identify issues, and contribute to continuous quality improvement in Utilization Management. Candidates should have a current...Work at office2 days per week
Blue Shield of CA
Lodi, CA3 days ago
