Average salary: $97,631 /yearly
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- ...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
$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- ...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
Los Angeles, CA2 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, CA13 hours ago $78.4k - $107.8k
...A healthcare insurance provider is looking for a Nurse Auditor 2 to perform clinical audits and ensure medical record accuracy. The role involves validating medical documentation and applying coding expertise on laboratory services. Candidates should have an active RN...SuggestedRemote workHumana
Hartford, CT2 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, OR2 days 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, CA2 days 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 - 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
- ...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
$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...SuggestedHourly pay- 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
- 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
- ...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 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...
$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...
- 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 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, CA2 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, CA2 days ago - ...A healthcare organization in San Diego seeks a Delegation Operations Nurse Auditor-LVN-Experienced to oversee utilization management audits and drive quality improvement efforts. The ideal candidate will handle reporting, problem identification, and ensure compliance with...Work at office
Blue Shield of CA
San Diego, CA2 days 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, CA2 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, CA1 day ago - A healthcare organization based in San Antonio, Texas is seeking a Charge Auditor Clinical who is a Registered Nurse. The successful candidate will coordinate observation charges and ensure proper billing and documentation adherence. Essential qualifications include an...Full time
$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 healthcare organization in San Antonio, Texas is seeking a Charge Auditor Clinical. This full-time position requires a Registered Nurse responsible for overseeing observation charges and ensuring compliance with documentation standards. Candidates should possess at least...Full time
- 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...
- 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...
