75 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

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

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...

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 TitleValidates 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 Responsibility1. 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. 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 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

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 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...

Hattiesburg Clinic seeks a Chart Auditor to review medical records for accuracy and billing purposes, ensuring E/M and CPT/ICD-10 coding align with policies. The role involves internal audits, staying current with guidelines, and promoting compliant coding practices. The candidate must hold CPC certification or RN with clinical experience; RN without coding certification must obtain CPC within 6 months, and CEMC within one year. #J-18808-Ljbffr

Overview We are seeking a Clinical Coding Auditor & Trainer to lead DRG and medical record auditing and deliver staff training programs. This role supports quality improvement, compliance, and education across clinical and coding teams. Responsibilities Conduct audits of staff work; report findings and improvement recommendations. Develop and deliver coding and DRG training programs. Revise policies and procedures to improve audit accuracy. Maintain training and audit records and track staff progress. Ensure compliance with company policies and healthcare standards. Requirements RN, PA, MD, APRN, DO, or MBBS license. Associate’s degree in Nursing or equivalent experience. 4+ years of DRG and/or medical record audit experience. 1 year of clinical experience in a hospital setting. Preferred Valid/current CPC or CIC Certification (AAPC) or CCS (AHIMA). RHIA/RHIT credentials. Prior training or auditing experience in managed care. Notes Primarily remote position...

Job Overview Clinical Coding Auditor & Trainer – Remote, NY, US. The position is primarily remote with a small travel expectation (twice a year to New York). Full‑time, permanent, salary $55,100–$99,000 / yr. Required Qualifications RN, PA, MD, APRN, DO, or MBBS license Associate’s degree in Nursing or equivalent experience 4+ years of DRG and/or Medical Record Audit experience 1 year of clinical experience in a hospital setting Valid/Current CPC or CIC Certification, or CCS through AHIMA Inpatient coding experience preferred Preferred or Nice-to-­Have Skills RHIA/RHIT credentials Training or auditing experience in a managed care or healthcare setting Years of Experience 4+ years in DRG/Medical Record Audit; 1 year in hospital clinical setting. Industry Experience Healthcare, specifically in a hospital or managed care setting. This is a remote position. Compensation: $55,100 – $99,000 per year. I was referred to this position by a current employee. #J-18808-Ljbffr

A healthcare solutions company is seeking a Clinical Coding Auditor & Trainer to work remotely. This role requires professional licensing (RN, PA, MD, etc.) and at least 4 years of experience in DRG and Medical Record Audits. The position involves occasional travel to New York. The salary ranges from $55,100 to $99,000 annually, providing a competitive compensation package for qualified candidates. #J-18808-Ljbffr

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....

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...

Summary With direction from the Director, the Nurse Auditor/ Senior Revenue Integrity Specialist is responsible for auditing itemized charges versus the patient medical record and other applicable hospital documentation, assigning modifiers to appropriate claims, researching edited claims for medical necessity, and advising the billing staff of appropriate HCPCS codes and modifiers. The Nurse Auditor/ Revenue Integrity Specialist works directly with revenue producing departments regarding lost charges, billing questions, and proper coding and charging. The nurse auditor reviews documentation on all Observation accounts for carve-out observation hours, the charge coding of ED Visits and Injection and Infusion charges. Essential Duties and Responsibilities 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. Work and review a high volume of accounts assigned to...

Essential Duties and Responsibilities These duties and responsibilities 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 scheduled. Assist Patient Account personnel with patient questions about itemized charges. Maintain a reporting system of audit activities and identify patterns and trends of results. Act as a resource for all hospital departments with 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 process and procedures. Work cooperatively with the Patient Accounting staff and other health‑care professionals in obtaining correct HCPCS codes and modifiers. Assist the Health Information Department with RAC requests,...

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.Think you've got what it takes?Job Duties & ResponsibilitiesAssess the treatment plan, clinical information, and medical necessity of all requested servicesUtilizes 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...

Hattiesburg Clinic seeks a Chart Auditor to review medical records for accuracy and billing purposes, ensuring E/M and CPT/ICD-10 coding align with policies. The role involves internal audits, staying current with guidelines, and promoting compliant coding practices. The candidate must hold CPC certification or RN with clinical experience; RN without coding certification must obtain CPC within 6 months, and CEMC within one year. #J-18808-Ljbffr

A healthcare technology firm is seeking a Nurse Coder DRG Auditor to validate coding accuracy and medical necessity of inpatient claims. The role involves applying industry standards and guidelines to perform DRG validations while collaborating within a team. Successful candidates will have an active RN license, relevant coding certifications, and experience in clinical practice. A competitive salary of $85,000 to $90,000 is offered, along with a comprehensive benefits package. #J-18808-Ljbffr