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Commission Rn Chart Auditor Jobs in Tennessee (NOW HIRING)

Tenet Health

Registered Nurse (RN)

Memphis, TN · On-site

As a Registered Nurse with us, you'll have the opportunity to make a meaningful impact in patients ... Maintain chart documentation to ensure all information about patient is completed and documented ...

Tenet Health

Registered Nurse (RN)

Memphis, TN · On-site

As a Registered Nurse with us, you'll have the opportunity to make a meaningful impact in patients ... Maintain chart documentation to ensure all information about patient is completed and documented ...

Tenet Health

Registered Nurse (RN)

Memphis, TN · On-site

Maintain chart documentation to ensure all information about patient is completed and documented correctly. Qualifications Education: High School Diploma or equivalent and completion of an accredited ...

Nightingale Respitcare

RN Needed

Nashville, TN · On-site

Registered Nurse A Registered Nurse (RN) is a licensed healthcare professional who provides and ... Chart patient progress and interventions * Ensure compliance with healthcare regulations Typical ...

Covenant Health

RN CARE MGR I

Knoxville, TN · On-site

As a Joint Commission Comprehensive Stroke Center, we provide leading-edge treatment for stroke ... chart findings to ensure patient is meeting daily objectives * The care manager modifies the case ...

Gentiva

Afterhours RN Care Manager

Morristown, TN · On-site

Clinical administrative responsibilities, workflow auditing, and survey readiness support are also ... Support the IDG process through chart reviews, plan of care updates, and interdisciplinary ...

Community Health Systems

RN

Knoxville, TN · On-site

The RN collaborates with physicians, nurses, and other healthcare professionals to ensure effective ... Participates in audits, chart reviews, and compliance checks to ensure adherence to standards of ...

Community Health Systems

RN

Farragut, TN · On-site

The Registered Nurse (RN) provides patient-centered care through the nursing process of assessment ... Participates in audits, chart reviews, and compliance checks to ensure adherence to standards of ...

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Showing results 21-40

All JobsRn Chart Auditor JobsCommission Rn Chart Auditor JobsCommission Rn Chart Auditor Jobs in Tennessee

Commission Rn Chart Auditor information

What is the difference between Commission Rn Chart Auditor vs Medical Records Reviewer?

AspectCommission Rn Chart AuditorMedical Records Reviewer
CredentialsRN license, auditing certificationsMedical background, certifications vary
Work EnvironmentHealthcare facilities, insurance companiesHospitals, clinics, insurance companies
Primary FocusAuditing clinical charts for compliance and accuracyReviewing medical records for completeness and correctness
Industry UsageHealthcare, insurance, billingHealthcare, legal, insurance

The main difference is that a Commission Rn Chart Auditor specializes in auditing clinical charts for compliance and accuracy, often with nursing credentials and specific auditing certifications. In contrast, a Medical Records Reviewer focuses on reviewing medical records for completeness and correctness, which may not require nursing licensure. Both roles are vital in healthcare and insurance industries but serve different functions related to record accuracy and compliance.

What are the most commonly searched types of Rn Chart Auditor jobs in Tennessee? The most popular types of Rn Chart Auditor jobs in Tennessee are:
What cities in Tennessee are hiring for Commission Rn Chart Auditor jobs? Cities in Tennessee with the most Commission Rn Chart Auditor job openings:
Commission Rn Chart Auditor jobs near you

Clinical Quality Assurance Auditor - Knoxville

BlueCross BlueShield of Tennessee

Chattanooga, TN • On-site, Remote

Full-time

This job post has expired 1 day ago. Applications are no longer accepted.

Job description

The Clinical Quality Assurance team is looking for an auditor based in the Knoxville, TN region.Our RN auditors perform reviews for network providers to ensure our members are receiving quality care in offices that adhere to our internal quality standards as well as those requirements from regulatory bodies such as Medicare, TennCare and NCQA.While working from home, the auditor will travel to provider offices in the Knoxville region to perform different review types for all lines of business.
You will be a strong candidate for this role if you have the following:
  • Registered Nurse (RN) with an active Tennessee license or a license from a Nurse Licensure Compact state.
  • 4 years of healthcare experience.
  • 1 year of managed care experience or experience with Quality Medical Record Review.
  • Experience with HEDIS and/or STARS data collection.
  • Strong analytical skills with the ability to identify trends and recommend process improvements.
  • We foster a culture where innovation is encouraged, supporting employees with the tools and resources needed to succeed while promoting growth, creativity, and continuous learning.
  • Candidate should reside in the Knoxville regional area of TN to facilitate onsite visits to provider offices.

Note:
  • Flexibility is required, as provider or leadership needs may occasionally require support outside standard business hours, including after 5:00 p.m

Job Responsibilities
  • Presenting and communicating audit results to appropriate parties; participates in the development of procedures and standards that support and enhance all lines of business' quality of care goals.
  • Schedule and perform routine facility, practitioner site, and medical record reviews, utilizing established clinical audit tools reflective of national accreditation standards and regulatory agency requirements.
  • Identifying and evaluating areas of exposure, potential problems and liabilities. Analyze clinical data to improve individual provider compliance with education; provide oversight for regional contract staff and coordinate the effort of retrieval of HEDIS and/or STARS records; complete medical record audits for HEDIS and/or STARS data collection or quality of care reviews as required.
  • Providing required documents and consulting support for quality and compliance audits.
  • Various immunizations and/or associated medical tests may be required for this position.

Job Qualifications
Education
  • Bachelor's Degree in Health Care related field or equivalent work experience.

Experience
  • 4 years - Health Care experience required.
  • 1 year - Managed care experience or experience with Quality Medical Record Review.

Skills/Certifications
  • Demonstrated presentation and team facilitation skills
  • Proficient in Microsoft Office (Outlook, Word, Excel and PowerPoint)
  • Excellent oral and written communication skills
  • Excellent time and project management skills
  • Strong analytical, planning, organizational and research skills

License
  • Registered Nurse (RN) with active license in the state of Tennessee or hold a license in the state of their residence if the state is participating in the Nurse Licensure Compact Law.

Employees who are required to operate either a BCBST-owned vehicle or a personal or rental vehicle for company business on a routine basis* will be automatically enrolled into the BCBST Driver Safety Program. The employee will also be required to adhere to the guidelines set forth through the program. This includes, maintaining a valid driver's license, auto insurance compliance with minimum liability requirements; as defined in the "Use of Non BCBST-Owned Vehicle" Policy (for employees driving personal or rental vehicles only); and maintaining an acceptable motor vehicle record (MVR). *The definition for "routine basis" is defined as daily, weekly or at regularly schedule times.
Number of Openings Available
1
Worker Type:
Employee
Company:
BCBST BlueCross BlueShield of Tennessee, Inc.
Applying for this job indicates your acknowledgement and understanding of the following statements:
BCBST will recruit, hire, train and promote individuals in all job classifications without regard to race, religion, color, age, sex, national origin, citizenship, pregnancy, veteran status, sexual orientation, physical or mental disability, gender identity, or any other characteristic protected by applicable law.
Further information regarding BCBST's EEO Policies/Notices may be found by reviewing the following page:
BCBST's EEO Policies/Notices
BlueCross BlueShield of Tennessee is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at BlueCross BlueShield of Tennessee via-email, the Internet or any other method without a valid, written Direct Placement Agreement in place for this position from BlueCross BlueShield of Tennessee HR/Talent Acquisition will not be considered. No fee will be paid in the event the applicant is hired by BlueCross BlueShield of Tennessee as a result of the referral or through other means.

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