98 rn coding auditor jobs found

Northwell Health is seeking a Registered Nurse CDI Auditor to validate acute inpatient coded charts and ensure documentation substantiates diagnostic information. This remote position in New York requires a NY RN license, a BSN, and strong knowledge of coding guidelines. You will audit DRG assignments, communicate changes to CDI staff, and ensure compliance with federal and state regulations. #J-18808-Ljbffr

Northwell Health is seeking a Registered Nurse CDI Auditor to validate acute inpatient coded charts and ensure documentation substantiates diagnostic information. This remote position in New York requires a NY RN license, a BSN, and strong knowledge of coding guidelines. You will audit DRG assignments, communicate changes to CDI staff, and ensure compliance with federal and state regulations. #J-18808-Ljbffr

DaMar Staffing seeks an experienced RN with HCS-D and COS-C Certification for OASIS to perform revenue cycle audits. The role involves validating DRG assignments and reviewing CDI changes, ensuring compliance with federal and state regulations. Remote position, requiring strong biomedical coding knowledge and clinical expertise. You will audit Medicare and non-Medicare charts, communicate DRG changes to staff, and handle reassignments with independent judgment. NY licensure is required. #J-18808-Ljbffr

Northwell Health in New York is seeking an experienced RN to validate Acute Inpatient coded charts, ensuring documentation supports DRG assignments. The role requires HCS-D and COS-C certificates for OASIS, with a focus on compliance and coding accuracy. This remote, NY-based position emphasizes audit of Medicare and non-Medicare charts, applying coding rules, and communicating changes to CDI staff. Bachelor's in Nursing and NY RN license are required, with CHHA experience preferred. #J-18808-Ljbffr

DaMar Staffing in New York seeks an RN with HCS-D and COS-C credentials to validate acute inpatient coded charts and substantiate diagnostic information from the medical record. This is a remote position with NY eligibility. You'll review DRG codes, audit charts for compliance with Federal and State regulations, and communicate changes to CDI staff. Requires NY RN license and bachelor’s degree in nursing. #J-18808-Ljbffr

DaMar Staffing is seeking a Registered Nurse with CDI auditing responsibilities to validate inpatient coding and DRG assignments based on documentation in the medical record. The role requires a nurse with a BSN, an active NY RN license, and experience with CHHA is preferred. The position involves reviewing charts for coding accuracy and ensuring compliance with federal and state regulations. #J-18808-Ljbffr

Job Title Validates Acute Inpatient coded charts to ensure the diagnostic information leading to the assignment can be substantiated by the documentation in the Medical Record. Seeking RN candidates with a HCS-D - Home Care Coding Specialist-Diagnosis, COS-C Certificate for OASIS Specialist-Clinical. Remote position in New York. Job Responsibility 1. Leverages clinical expertise to identify and validate DRG code assignment. 2. Full review of CDI suggested code changes. 3. Demonstrates comprehensive knowledge of coding guidelines and principals; performs coding audits for optimization. 4. Audits and reviews Medicare/non-Medicare charts to ensure that proper standards are maintained in compliance with Federal and State regulations. 5. Applies coding rules and regulations to the validation review process. 6. Reviews codes on Medicare/non-Medicare charts for compliance to rules and conventions. 7. Communicates DRG changes and rationale to the coding and CDI staff. 8....

Job Description Validates Acute Inpatient coded charts to ensure the diagnostic information leading to the assignment can be substantiated by the documentation in the Medical Record. Seeking RN candidates with a HCS-D - Home Care Coding Specialist-Diagnosis, COS-C Certificate for OASIS Specialist-Clinical. Remote position in New York. Job Responsibility Leverages clinical expertise to identify and validate DRG code assignment. Full review of CDI suggested code changes Demonstrates comprehensive knowledge of coding guidelines and principals; performs coding audits for optimization. Audits and reviews Medicare/non-Medicare charts to ensure that proper standards are maintained in compliance with Federal and State regulations. Applies coding rules and regulations to the validation review process. Reviews codes on Medicare/non-Medicare charts for compliance to rules and conventions. Communicates DRG changes and rationale to the coding and CDI staff. Identifies appropriate coding...

Revenue Cycle AuditValidates Acute Inpatient coded charts to ensure the diagnostic information leading to the assignment can be substantiated by the documentation in the Medical Record.Seeking RN candidates with a HCS-D - Home Care Coding Specialist-Diagnosis, COS-C Certificate for OASIS Specialist-Clinical. Remote positionJob Responsibility1. Leverages clinical expertise to identify and validate DRG code assignment.2. Full review of CDI suggested code changes3. Demonstrates comprehensive knowledge of coding guidelines and principals; performs coding audits for optimization.4. Audits and reviews Medicare/non-Medicare charts to ensure that proper standards are maintained in compliance with Federal and State regulations.5. Applies coding rules and regulations to the validation review process.6. Reviews codes on Medicare/non-Medicare charts for compliance to rules and conventions.7. Communicates DRG changes and rationale to the coding and CDI staff.8. Identifies appropriate coding...

The Opportunity Are you an experienced Inpatient RN ready to step away from the bedside without losing your clinical edge As part of the Centene/Fidelis Care team you will ensure the clinical accuracy of care for 28 million members.This is a high-level auditing and education role designed for nurses who love the puzzle of clinical documentation and the reward of teaching others.Key OutcomesDrive Accuracy:Develop and lead complex inpatient coding audits to ensure medical necessity and documentation excellence.Educate Teams:Design training programs that translate complex clinical data into actionable knowledge for staff.Remote Flexibility:Work primarily from home with only two scheduled trips to New York per year.Qualifications :Requirements (Strictly Enforced)Active RN License:Must be currently licensed.Acute Care Foundation:You must have direct nursing experience in an Inpatient Hospital setting.(Candidates with only outpatient or clinic experience will not be considered for this...

Job Title Validates Acute Inpatient coded charts to ensure the diagnostic information leading to the assignment can be substantiated by the documentation in the Medical Record. Job Responsibilities Leverages clinical expertise to identify and validate DRG code assignment. Full review of CDI suggested code changes. Demonstrates comprehensive knowledge of coding guidelines and principals; performs coding audits for optimization. Audits and reviews Medicare/non-Medicare charts to ensure that proper standards are maintained in compliance with Federal and State regulations. Applies coding rules and regulations to the validation review process. Reviews codes on Medicare/non-Medicare charts for compliance to rules and conventions. Communicates DRG changes and rationale to the coding and CDI staff. Identifies appropriate coding changes necessary to provide the most valid documentation in compliance with Federal and State regulations. Operates under general guidance and work assignments...

Job TitleValidates Acute Inpatient coded charts to ensure the diagnostic information leading to the assignment can be substantiated by the documentation in the Medical Record.Job ResponsibilitiesLeverages clinical expertise to identify and validate DRG code assignment.Full review of CDI suggested code changes.Demonstrates comprehensive knowledge of coding guidelines and principals; performs coding audits for optimization.Audits and reviews Medicare/non-Medicare charts to ensure that proper standards are maintained in compliance with Federal and State regulations.Applies coding rules and regulations to the validation review process.Reviews codes on Medicare/non-Medicare charts for compliance to rules and conventions.Communicates DRG changes and rationale to the coding and CDI staff.Identifies appropriate coding changes necessary to provide the most valid documentation in compliance with Federal and State regulations.Operates under general guidance and work assignments are varied and...

Job TitleValidates Acute Inpatient coded charts to ensure the diagnostic information leading to the assignment can be substantiated by the documentation in the Medical Record.Job ResponsibilitiesLeverages clinical expertise to identify and validate DRG code assignment.Full review of CDI suggested code changes.Demonstrates comprehensive knowledge of coding guidelines and principals; performs coding audits for optimization.Audits and reviews Medicare/non-Medicare charts to ensure that proper standards are maintained in compliance with Federal and State regulations.Applies coding rules and regulations to the validation review process.Reviews codes on Medicare/non-Medicare charts for compliance to rules and conventions.Communicates DRG changes and rationale to the coding and CDI staff.Identifies appropriate coding changes necessary to provide the most valid documentation in compliance with Federal and State regulations.Operates under general guidance and work assignments are varied and...

Job TitleValidates Acute Inpatient coded charts to ensure the diagnostic information leading to the assignment can be substantiated by the documentation in the Medical Record.Job ResponsibilitiesLeverages clinical expertise to identify and validate DRG code assignment.Full review of CDI suggested code changes.Demonstrates comprehensive knowledge of coding guidelines and principals; performs coding audits for optimization.Audits and reviews Medicare/non-Medicare charts to ensure that proper standards are maintained in compliance with Federal and State regulations.Applies coding rules and regulations to the validation review process.Reviews codes on Medicare/non-Medicare charts for compliance to rules and conventions.Communicates DRG changes and rationale to the coding and CDI staff.Identifies appropriate coding changes necessary to provide the most valid documentation in compliance with Federal and State regulations.Operates under general guidance and work assignments are varied and...

FHAS Federal Hearings & Appeals Services, Inc. is seeking a Nurse Reviewer RN for a full-time on-site role in Wilkes-Barre, PA. The position focuses on timely review and determination of medical claims, appeals, and prior authorizations, with emphasis on accurate coding review and adherence to Medicare regulations. The ideal candidate holds an active RN license, has 1+ years of clinical experience, and preferably a coding certification. #J-18808-Ljbffr

POSITION SUMMARY: Reporting to the VP of Compliance, the Compliance Auditor is responsible for ongoing analysis and review of coding accuracy, medical necessity documentation, and regulatory compliance in patient records. ESSENTIAL JOB FUNCTIONS/RESPONSIBILITIES: Conduct compliance focused monitoring and audits related to coding accuracy, medical necessity, supporting documentation and other operational functions. Conducts ad hoc reviews and audits based on high risk, problem prone, or otherwise specified areas. Maintains tools, reports, data, metrics, benchmarking, tracking, and trending patient and compliance data. Participates in various committees to address risks and opportunities for improvement, to report on compliance data, and collaborate in process improvement initiatives. Provide reports to management on compliance metrics and audit findings as requested. Requirements EDUCATION AND QUALIFICATIONS: RN or LPN required A minimum of three to five...

Overview Ardent Health is a leading provider of healthcare in growing mid-sized urban communities across the U.S. With a focus on people and investments in innovative services and technologies, Ardent is passionate about making healthcare better and easier to access. Through its subsidiaries, Ardent delivers care through a system of 30 acute care hospitals, 24,000+ team members and more than 280 sites of care with over 1,800 affiliated providers across six states. Position Summary The Hospital Auditor is responsible for reviewing hospital (inpatient and outpatient) to ensure accuracy, completeness, and compliance with regulatory guidelines and coding standards. This role supports the team’s broader mission by identifying documentation gaps, validating coding accuracy, and assessing the effectiveness of hospital practices. Through targeted feedback and education, the Hospital Auditor helps strengthen documentation quality, promote compliant billing, and safeguard reimbursement...

Job Title Essential Duties and Responsibilities These duties and responsibilities described below represent the general tasks performed on a daily basis; other tasks may be assigned. Coordinate, supervise, and respond to third-party patient bill audits. Perform patient-requested audits in a timely manner. Perform random quality audits as schedule permits. Assist Patient Account personnel with patient questions about itemized charges. Maintain reporting systems for audit activities and identify patterns and trends in results. Act as a resource for all hospital departments regarding charging questions and issues. Routinely review inpatient and outpatient records for appropriate coding and charging. Provide educational sessions for revenue-producing departments regarding appropriate charging processes and procedures. Work cooperatively with the Patient Accounting staff and other healthcare professionals in obtaining correct HCPCS codes and modifiers. Assist the Health...

Medical Compliance AuditorWe are searching for a Medical Compliance Auditor - someone who works well in a fast-paced setting. In this position, you will review and approve or deny medical claim appeals and perform clinical audits of medical records submitted in support of services billed by providers. This process includes clinical judgment, utilization review, application of product benefits, understanding of regulatory requirements for Medicaid managed care and fraud and abuse, and verification of medical necessity utilizing nationally recognized criteria. Job Duties & Responsibilities Assess the treatment plan, clinical information, and medical necessity of all requested services Utilizes established criteria to appropriately review billed services within established timeframe required. Consults with medical directors and clinical staff regarding patient's history and current care needs and whether services billed were appropriate. Refers case failing medical necessity...

Company Overview PACS Group, Inc. is a holding company investing in post-acute healthcare facilities, professionals, and ancillary services. Founded in 2013, PACS Group is one of the largest post-acute platforms in the United States. Its independent subsidiaries operate 325 post-acute care facilities with 47,000 employees across 17 states serving over 31,000 patients daily. PACS business support division, PACS Services, provides technology and administrative support services — accounting, finance, human resources, compliance, payroll, AR/AP, legal, risk management, information technology, corporate communication, and other business advice and support — to their healthcare facilities, reducing administrative burdens so their leadership and care teams can focus on the care, well-being, and quality of life of their patients and residents. PACS is one of Utah’s Best Companies to work for. It has also been recognized as one of Utah’s Fastest Growing Companies for multiple years. Job...

Job Description The Specialist OR Biller / Chart Auditor works under the supervision of the Perioperative Services Director or designee and serves as a subject matter expert for Operating Room Charge capture, billing accuracy, and revenue integrity. This role is responsible for the audit, validation, and reconciliation of intraoperative documentation, supplies, implants, devices and time-based services to ensure all billable components of surgical cases across surgical service lines are accurately captured, posted, and billed across the system. and special ordering regarding supplies, implants, and devices in the operative setting. This position plays a critical role in preventing revenue leakage, supporting compliance, and ensuring alignment between clinical documentation, EMR charge workflows, and downstream billing processes across all perioperative service lines. The Specialist provides guidance and education to OR caregivers and collaborates closely with Revenue Cycle, Supply...

Nurse Coder Drg Auditor Iii This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Nurse Coder Drg Auditor Iii based in United States. This role serves as a subject matter expert in clinical coding, claims auditing, and payment integrity. You will independently audit inpatient and outpatient claims using coding and clinical guidelines alongside supporting medical documentation. The position combines clinical expertise with advanced coding validation, quality assurance, and appeal response responsibilities. You will evaluate diagnoses, procedures, sequencing, discharge statuses, and levels of care to identify accurate and compliant claim outcomes. The role also provides opportunities to influence coding standards, develop new concepts, and contribute to strategic recommendations. Strong collaboration with internal teams and, when needed, clients will be essential to communicating audit findings...

Elara Caring is seeking a Senior Compliance Auditor (RN) to join our remote team. This role focuses on auditing skilled home health, hospice, PCS, and behavioral health, driving education based on findings and guiding policy updates. The position requires a Registered Nurse with extensive coding/billing audit experience and leadership capabilities. You will report to the Compliance Audit Manager and play a key role in preventing issues, ensuring regulatory alignment, and supporting operational #J-18808-Ljbffr

Overview Ardent Health is a leading provider of healthcare in growing mid-sized urban communities across the U.S. With a focus on people and investments in innovative services and technologies, Ardent is passionate about making healthcare better and easier to access. Through its subsidiaries, Ardent delivers care through a system of 30 acute care hospitals, 24,000+ team members and more than 280 sites of care with over 1,800 affiliated providers across six states. POSITION SUMMARY: The Hospital Auditor is responsible for reviewing hospital (inpatient and outpatient) to ensure accuracy, completeness, and compliance with regulatory guidelines and coding standards. This role supports the team's broader mission by identifying documentation gaps, validating coding accuracy, and assessing the effectiveness of hospital practices. Through targeted feedback and education, the Hospital Auditor helps strengthen documentation quality, promote compliant billing, and safeguard reimbursement...