100 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

Northwell Health in Glen Cove, NY, seeks a Registered Nurse with ICD coding and inpatient audit experience to validate acute inpatient coded charts. You will ensure the documentation supports the diagnostic information and DRG assignments, and participate in coding reviews to optimize accuracy. The role requires nursing licensure in New York and familiarity with ICD coding to perform audits in compliance with federal and state regulations. #J-18808-Ljbffr

Humana is seeking a Nurse Auditor 2 to perform clinical audit/validation of medical records to ensure accurate diagnosis coding and compliant billing for optimal reimbursement. The role involves interpreting documentation, identifying high-risk HCCs, and recommending improvements. The position is remote with occasional travel to Humana offices for training or meetings; typical hours are Monday–Friday, with start times in the home time zone. Requires RN license and inpatient care experience. #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.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...

Northwell Health is seeking an Acute Inpatient Coding Validation professional in New York to validate DRG assignments based on the documentation in the Medical Record. You will perform full reviews of CDI suggested code changes and apply coding rules. Audits cover Medicare and non-Medicare charts to ensure compliance with federal and state regulations. Candidates should hold a NY RN license with a BSN or equivalent and ICD coding experience; inpatient rehab 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...

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...

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 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

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 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

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

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...

Compliance AuditorThe Compliance Auditor reports to the Regulatory Audit Manager and performs audits to evaluate adherence to laws, regulations and policies by reviewing records, analyzing data, and interviewing staff and stakeholders.Position Purpose:The Compliance Auditor reports to the Regulatory Audit Manager and performs audits to evaluate adherence to laws, regulations and policies by reviewing records, analyzing data, and interviewing staff and stakeholders. These audits include but are not limited to services identified as high-risk via the annual risk assessment, OIG-CMS-PGBA workplan areas, ad hoc audit requests, and "for cause" coding and billing concerns.The audit scope includes:a) The regulatory and industry research needed for audit planningb) Pre and post audit meetings with stakeholdersc) Cohesive audit report that communicates results and includes a corrective action plan if warranted, andd) Education and training to stakeholders as neededRequirements (Education,...

Compliance Auditor II - Compliance - 320359The Compliance Auditor II will assist in the overall quality, compliance, and auditing activities to ensure compliance of standard operating procedures, corporate policies, industry standards, and applicable federal and state laws. Conducts audit activities, reporting and communicates audit findings. Works in conjunction with Compliance Director on compliance work plans, internal and external audits and reviews, and provides assurance that the organization is operating in an efficient and effective manner.Responsibilities:Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.Manages compliance audit activities pertaining to compliance and coordinates with Corporate Compliance Director and Senior Leadership as it relates to such auditsResponsible for answering inquiries related to professional documentation, coding, and billing regulatory requirements. Work with...

Coding Auditor (ICD-10) Position: Coding Auditor (ICD-10) Duration: Full-Time Location: Newark/Wall NJ Job Summary: This position is responsible for conducting on site audits of hospital billing and coding practices and desk audits; forms development, profiling and tracking institutional audit trends. Performs and finalizes multiple per diem, bill verification, DRG Validation (utilization review audits) and credit balance. Additionally provides guidance/instruction to various stakeholders on ICD9-CM, ICD-10, DRG assignment payment and auditing. Responsibilities: • Identifies and presents billing discrepancies found during audit and coordinates referral of improper claim payments through the appropriate channels. • Identifies error trends as they relate to medical record and or billing documentation or misinterpretation of provider contract stipulations. • Compiles statistics and other audit information to present to accounts, regulatory agencies, and internal...

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...

6 days ago Be among the first 25 applicants This range is provided by TalentPlug LLC. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range $55,100.00/yr - $99,000.00/yr Direct message the job poster from TalentPlug LLC Job Title Clinical Coding Auditor & Trainer Job Location Remote (Candidates must be residents of New York) Summary The Clinical Coding Auditor & Trainer position is primarily remote with a small travel expectation on an annual basis. Candidates must be willing to travel to New York twice a year to be considered for the position. Position Purpose Responsible for developing and conducting training and quality auditing programs for the Diagnosis Related Group (DRG) and Medical Record Audit Programs for Fidelis Care. Applicants must be willing to travel to New York twice a year. Responsibilities Conducts auditing of work performed by staff and present findings and...

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

Trend Health Partners is seeking a Nurse Coding Auditor to review medical records and itemized bills for accurate CPT/HCPCS/revenue code usage on hospital claims. The role emphasizes CMS guideline adherence, documentation review, and audit accuracy in a dynamic, tech-enabled environment. Applicants should hold an active coding certification and strong Excel skills; RN license preferred. Competitive pay and robust benefits accompany a collaborative, growth-focused team. #J-18808-Ljbffr

1 day ago Be among the first 25 applicants This range is provided by TalentPlug LLC. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range $55,100.00/yr - $99,000.00/yr Direct message the job poster from TalentPlug LLC The Clinical Coding Auditor & Trainer position is primarily remote with a small travel expectation on an annual basis. Candidates must be willing to travel to New York twice a year to be considered for the position. Position Purpose: Responsible for developing and conducting training and quality auditing programs for the Diagnosis Related Group (DRG) and Medical Record Audit Programs for Fidelis Care. The Clinical Coding Auditor & Trainer position is primarily remote with a small travel expectation on an annual basis. Candidates must be willing to travel to New York twice a year to be considered for the position. Responsibilities: Conducts auditing of work performed by staff and present...