Clinical Director, Pre-Bill DRG Review - Quality Assurance, Training & Education (RN, MD/DO, or PA) (FT/Remote) CorroHealthClinical Director, Pre-Bill DRG Review - Quality Assurance, Training & Education (RN, MD/DO, or PA) (FT/Remote)New JerseyRemoteThis role is responsible for designing, implementing, and continuously improving the quality assurance framework that governs pre-bill coding review, as well as building and leading the training and education infrastructure that supports coding staff, clinical documentation integrity (CDI) specialists, and auditors. The Director partners closely with HIM leadership, CDI, Compliance, Revenue Cycle, and Physician Advisors to reduce DRG mismatches, denials, and revenue leakage while maintaining strict adherence to Official Coding Guidelines, CMS regulations, and payer-specific requirements.
Appeals Registered Nurse Wisconsin Physicians Service Insurance CorpAppeals Registered NurseTrenton, NJRemoteWe are open to remote work in the following approved states: Colorado, Florida, Georgia, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, Nebraska, New Jersey, North Carolina, Ohio, South Carolina, Texas, Virginia, Wisconsin. The Appeals Nurse examines medical records and claims information for first-level appeal cases to determine whether services provided were medically necessary and meet Medicare coverage guidelines in accordance with Medicare regulations and policies.
Case Manager Registered Nurse - Field (Somerset County, New Jersey) - New Hire Bonus Available CVS HealthCase Manager Registered Nurse - Field (Somerset County, New Jersey) - New Hire Bonus AvailableNew JerseyRemoteWith compassionate attention and excellent communication, we collaborate with members, providers, and community organizations to address the full continuum of our members’ health care and social determinant needs. Collaborates with supervisor and other key stakeholders in the member’s healthcare in overcoming barriers in meeting goals and objectives, presents cases at interdisciplinary case conferences.
Registered Field Nurse Homewatch CareGivers of Cape MayRegistered Field NurseAtlantic County, NJRemotePart timeWe believe exceptional care begins with caring relationships and a culture of clinical and service excellence that empowers individuals and improves the quality of life for the clients, families, and caregivers who serve alongside us. Supportive Leadership: Work alongside a Registered Nurse with more than 25 years of clinical and healthcare leadership experience who understands the value of teamwork and professional support.