- Medical Mutual of Ohio (OH)
- …RN experience, DRG,_** **_and/or_** **_hospital bill auditing experience._** **Responsibilities** ** Clinical Auditor ** + **Audits outpatient, inpatient and ... with payment recovery staff.** + **Performs other duties as assigned.** **Sr Clinical Auditor ** + **Audits outpatient, inpatient and professional claims from… more
- LA Care Health Plan (Los Angeles, CA)
- Delegation Oversight Clinical Auditor RN II Job Category: Clinical Department: Audit Services Location: Los Angeles, CA, US, 90017 Position Type: Full Time ... public agency created by the state of California to provide health coverage to low-income Los Angeles County residents....to achieve that purpose. Job Summary The Delegation Oversight Clinical Auditor RN II is responsible for… more
- Sevita (Baltimore, MD)
- …opportunities for the people we serve and for our employees. **Summary** The Clinical Compliance Auditor is responsible for collaborating with Operations and ... across all Company business units and service lines. Ensures that existing clinical audit standards and procedures are best practice according to legal and… more
- Elevance Health (Middletown, NY)
- **Diagnosis Related Group Clinical Validation Auditor ** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live ... 50 miles of one of our PulsePoint locations. The **Diagnosis Related Group Clinical Validation Auditor ** is responsible for auditing inpatient medical records to… more
- Providence (Beaverton, OR)
- …retain the best people, we must empower them._** **Providence Health Plan is calling a Clinical Nurse Auditor , HEDIS who will:** + Be responsible for conducting ... clinical quality audits for the Quality Department + Identify...**This posting is for multiple openings of a Nurse Auditor , HEDIS** + **This position is affiliated with Providence… more
- Elevance Health (Metairie, LA)
- ** Clinical Quality Auditor Sr.** **Location** : The territory for this position is the State of Louisiana. The ** Clinical Quality Auditor Sr.** is ... in nursing, health sciences, health management or a related clinical field and minimum of 5 years of experience...or any combination of education and experience, which would provide an equivalent background. Current unrestricted RN license in… more
- Elevance Health (Washington, DC)
- ** Clinical Provider Auditor I** **Supports the Payment Integrity line of business** _Location: This position will work a hybrid model (remote and office). ... is determined to recover, eliminate and prevent unnecessary medical-expense spending. The ** Clinical Provider Auditor I** is responsible for identifying… more
- Elara Caring (Broken Arrow, OK)
- …families. This means you have countless ways to make a difference in your role as Clinical Chart Auditor by helping your team to reach their full potential. To ... environment, and that perfectly aligns with our culture. Our Clinical Chart Auditors are truly valued, and essential, in...law._ _Elara Caring participates in E-Verify and we will provide the Federal Government with your Form I-9 information… more
- MicroVention, Inc. (Aliso Viejo, CA)
- **12071BR** **Title:** Sr Auditor , Clinical Trials **Job Description:** Provide support to all aspects of the Clinical Quality Assurance (CQA) function ... etc.); and planning, execution, reporting, root cause analysis investigation, and closure. Provide comprehensive compliance direction to clinical study teams and… more
- Actalent (St. Louis, MO)
- … documentation, and modify business processes to measure member outcomes. Assess provider performance and quality of care through clinical case reviews. ... Quality Improvement Auditor (RN) Position Purpose: Lead medical record audits,...* Lead clinical audits for provider medical records both remotely via electronic medical records… more