Utilization Manager
Durham, NC · On-site
Duke University Health System has 6000 + registered nurses * Quality of Life: Living in the ... Medical Chart Auditor Completes retrospective medical necessity reviews for compliance with ...
Utilization Manager
Durham, NC · On-site
Duke University Health System has 6000 + registered nurses * Quality of Life: Living in the ... Medical Chart Auditor Completes retrospective medical necessity reviews for compliance with ...
Duke University Health System has 6000 + registered nurses * Quality of Life: Living in the ... Medical Chart Auditor Completes retrospective medical necessity reviews for compliance with ...
Duke University Health System has 6000 + registered nurses * Quality of Life: Living in the ... Medical Chart Auditor Completes retrospective medical necessity reviews for compliance with ...
Duke University Health System has 6000 + registered nurses * Quality of Life: Living in the ... Medical Chart Auditor Completes retrospective medical necessity reviews for compliance with ...
Duke University Health System has 6000 + registered nurses * Quality of Life: Living in the ... Medical Chart Auditor Completes retrospective medical necessity reviews for compliance with ...
CHARGE CODE AUDITOR
Durham, NC · On-site
Duke University Health System has 6000 + registered nurses * Quality of Life: Living in the ... Ability to remain focused, organized, and detail-oriented during prolonged periods of chart review.
CHARGE CODE AUDITOR
Durham, NC · On-site
Duke University Health System has 6000 + registered nurses * Quality of Life: Living in the ... Ability to remain focused, organized, and detail-oriented during prolonged periods of chart review.
CHARGE CODE AUDITOR
Durham, NC · On-site
Duke University Health System has 6000 + registered nurses * Quality of Life: Living in the ... Ability to remain focused, organized, and detail-oriented during prolonged periods of chart review.
CHARGE CODE AUDITOR
Durham, NC · On-site
Duke University Health System has 6000 + registered nurses * Quality of Life: Living in the ... Ability to remain focused, organized, and detail-oriented during prolonged periods of chart review.
Duke University Health System has 6000 + registered nurses * Quality of Life: Living in the ... Ability to remain focused, organized, and detailoriented during prolonged periods of chart review.
Duke University Health System has 6000 + registered nurses * Quality of Life: Living in the ... Ability to remain focused, organized, and detailoriented during prolonged periods of chart review.
CHARGE CODE AUDITOR
Durham, NC · On-site
Duke University Health System has 6000 + registered nurses * Quality of Life: Living in the ... Ability to remain focused, organized, and detailoriented during prolonged periods of chart review.
CHARGE CODE AUDITOR
Durham, NC · On-site
Duke University Health System has 6000 + registered nurses * Quality of Life: Living in the ... Ability to remain focused, organized, and detailoriented during prolonged periods of chart review.
Utilizing chart reviews to verify critical elements including but not limited to: provider ... Working knowledge and completion of appropriate Joint Commission and other regulatory requirements.
Utilizing chart reviews to verify critical elements including but not limited to: provider ... Working knowledge and completion of appropriate Joint Commission and other regulatory requirements.
After-Hours Hospice RN Care Manager in Henderson, NC
Henderson, NC · On-site
$69K - $87K/yr
Clinical administrative responsibilities, workflow auditing, and survey readiness support are also ... Support the IDG process through chart reviews, plan of care updates, and interdisciplinary ...
New
After-Hours Hospice RN Care Manager in Henderson, NC
Henderson, NC · On-site
$69K - $87K/yr
Clinical administrative responsibilities, workflow auditing, and survey readiness support are also ... Support the IDG process through chart reviews, plan of care updates, and interdisciplinary ...
New
Optimize Clinical Workflows - Assist with chart preparation and treatment planning to streamline ... Active and Unrestricted Registered Nurse (RN) license * Life Support Certifications - BLS ...
Optimize Clinical Workflows - Assist with chart preparation and treatment planning to streamline ... Active and Unrestricted Registered Nurse (RN) license * Life Support Certifications - BLS ...
After-Hours Hospice RN Care Manager in Chapel Hill, NC
Chapel Hill, NC · On-site
$61K - $77K/yr
Clinical administrative responsibilities, workflow auditing, and survey readiness support are also ... Support the IDG process through chart reviews, plan of care updates, and interdisciplinary ...
New
After-Hours Hospice RN Care Manager in Chapel Hill, NC
Chapel Hill, NC · On-site
$61K - $77K/yr
Clinical administrative responsibilities, workflow auditing, and survey readiness support are also ... Support the IDG process through chart reviews, plan of care updates, and interdisciplinary ...
New
Clinical administrative responsibilities, workflow auditing, and survey readiness support are also ... Support the IDG process through chart reviews, plan of care updates, and interdisciplinary ...
New
Clinical administrative responsibilities, workflow auditing, and survey readiness support are also ... Support the IDG process through chart reviews, plan of care updates, and interdisciplinary ...
New
Utilizing chart reviews to verify critical elements including but not limited to: provider ... Working knowledge and completion of appropriate Joint Commission and other regulatory requirements.
Utilizing chart reviews to verify critical elements including but not limited to: provider ... Working knowledge and completion of appropriate Joint Commission and other regulatory requirements.
Utilizing chart reviews to verify critical elements including but not limited to: provider ... Working knowledge and completion of appropriate Joint Commission and other regulatory requirements.
Utilizing chart reviews to verify critical elements including but not limited to: provider ... Working knowledge and completion of appropriate Joint Commission and other regulatory requirements.
Utilizing chart reviews to verify critical elements including but not limited to: provider ... Working knowledge and completion of appropriate Joint Commission and other regulatory requirements.
Utilizing chart reviews to verify critical elements including but not limited to: provider ... Working knowledge and completion of appropriate Joint Commission and other regulatory requirements.
Utilizing chart reviews to verify critical elements including but not limited to: provider ... Working knowledge and completion of appropriate Joint Commission and other regulatory requirements.
Utilizing chart reviews to verify critical elements including but not limited to: provider ... Working knowledge and completion of appropriate Joint Commission and other regulatory requirements.
Utilizing chart reviews to verify critical elements including but not limited to: provider ... Working knowledge and completion of appropriate Joint Commission and other regulatory requirements.
Utilizing chart reviews to verify critical elements including but not limited to: provider ... Working knowledge and completion of appropriate Joint Commission and other regulatory requirements.
Utilizing chart reviews to verify critical elements including but not limited to: provider ... Working knowledge and completion of appropriate Joint Commission and other regulatory requirements.
Utilizing chart reviews to verify critical elements including but not limited to: provider ... Working knowledge and completion of appropriate Joint Commission and other regulatory requirements.
Clinical administrative responsibilities, workflow auditing, and survey readiness support are also ... Support the IDG process through chart reviews, plan of care updates, and interdisciplinary ...
New
Clinical administrative responsibilities, workflow auditing, and survey readiness support are also ... Support the IDG process through chart reviews, plan of care updates, and interdisciplinary ...
New
Clinical administrative responsibilities, workflow auditing, and survey readiness support are also ... Support the IDG process through chart reviews, plan of care updates, and interdisciplinary ...
New
Clinical administrative responsibilities, workflow auditing, and survey readiness support are also ... Support the IDG process through chart reviews, plan of care updates, and interdisciplinary ...
New
Commission Rn Chart Auditor information
See Raleigh, NC salary details
$13.55 - $15.61
5% of jobs
$15.61 - $17.67
9% of jobs
$18.86 is the 25th percentile. Wages below this are outliers.
$17.67 - $19.73
18% of jobs
The median wage is $21.15 / hr.
$19.73 - $21.80
25% of jobs
$21.80 - $23.86
11% of jobs
$25.70 is the 75th percentile. Wages above this are outliers.
$23.86 - $25.92
7% of jobs
$25.92 - $27.98
7% of jobs
$27.98 - $30.04
6% of jobs
$30.04 - $32.10
4% of jobs
$32.10 - $34.16
3% of jobs
$34.16 - $36.22
3% of jobs
$13
$23
$36
How much do commission rn chart auditor jobs pay per hour?
As of Jul 12, 2026, the average hourly pay for commission rn chart auditor in Raleigh, NC is $23.34, according to ZipRecruiter salary data. Most workers in this role earn between $18.94 and $26.88 per hour, depending on experience, location, and employer.
How to become an RN chart reviewer?
To become an RN chart reviewer, registered nurses typically need clinical experience in healthcare settings and familiarity with medical documentation and coding. Additional training or certification in medical record review or quality assurance can enhance qualifications, and proficiency with electronic health record systems is often required.
What is the highest paid RN position?
The highest paid RN position is typically a Nurse Anesthetist (CRNA), who can earn significantly higher salaries than other registered nurses due to advanced training and certification. CRNAs often work in specialized settings such as surgical or anesthesia teams and require a master's degree or higher in nurse anesthesia. Salaries for CRNAs can exceed $180,000 annually, depending on experience and location.
What type of auditor gets paid the most?
In the auditing field, senior auditors, especially those with specialized skills such as forensic or IT auditing, tend to earn the highest salaries. Certified professionals like Certified Public Accountants (CPAs) or Certified Internal Auditors (CIAs) also typically receive higher pay due to their expertise and experience levels.
What is the difference between Commission Rn Chart Auditor vs Medical Records Reviewer?
| Aspect | Commission Rn Chart Auditor | Medical Records Reviewer |
|---|---|---|
| Credentials | RN license, auditing certifications | Medical background, certifications vary |
| Work Environment | Healthcare facilities, insurance companies | Hospitals, clinics, insurance companies |
| Primary Focus | Auditing clinical charts for compliance and accuracy | Reviewing medical records for completeness and correctness |
| Industry Usage | Healthcare, insurance, billing | Healthcare, 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.
How much do chart audits make?
Commission Rn Chart Auditors typically earn between $20 and $40 per hour, depending on experience, certifications, and the complexity of the audits. Some auditors work on a per-claim basis or receive a flat fee for each chart reviewed, which can increase overall earnings. Salaries can vary based on location, employer, and whether the role is part-time or full-time.
What are the most commonly searched types of Rn Chart Auditor jobs in Raleigh, NC? The most popular types of Rn Chart Auditor jobs in Raleigh, NC are:
What cities near Raleigh, NC are hiring for Commission Rn Chart Auditor jobs? Cities near Raleigh, NC with the most Commission Rn Chart Auditor job openings:
Duke Health rating
7.2
Based on 248 frontline employees who took The Breakroom Quiz
326th of 881 rated healthcare providers
Job description
At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together.
About Duke Regional Hospital
Pursue your passion for caring with Duke Regional Hospital in Durham, North Carolina. With 388 beds it is the second largest of Duke Health's four hospitals and offers a comprehensive range ofmedical, surgical, and diagnostic services, including orthopedics, weight-loss surgery, women's services, and heart and vascular services.
Duke Nursing Highlights:
Every other weekend 8 hours 5 days a week
Assesses for accuracy in the assignment of patient class (status) to reflect congruence with clinical condition, physician intent, and utilization review outcomes with current rules and regulatory requirements. Supports the medical chart audit process by ensuring accurate, timely, and informative clinical review documentation that supports the medical necessity/level of care. Supports denials management by documenting activities related to denials adjudication according to departmental guidelines and actively works to overturn threatened denial activities. Complies with current rules and regulatory requirements pertaining to utilization management. Initiates actions to obtain appropriate determinations. Collaborates with members of the healthcare team to address, understand, and mitigate excess/avoidable days. Serves as primary source of consultation for issues related to patient class (status) determination.
Work Performed
Knowledge, Skills and Abilities
Level Characteristics
N/A
Minimum Qualifications
Education
BSN required
Experience
Minimum of three years recent acute clinical practice or related health care experience.
Degrees, Licensures, Certifications
Requires Case Management Certification (ACM, CCM or ANCC) within 2 years of hire. BSN required and must have current or compact RN licensure in state of NC. BLS certification required.
Duke is an Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex (including pregnancy and pregnancy related conditions), sexual orientation or military status.
Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas-an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values.
Essential Physical Job Functions:
Certain jobs at Duke University and Duke University Health System may include essential job functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.
About Duke Regional Hospital
Pursue your passion for caring with Duke Regional Hospital in Durham, North Carolina. With 388 beds it is the second largest of Duke Health's four hospitals and offers a comprehensive range ofmedical, surgical, and diagnostic services, including orthopedics, weight-loss surgery, women's services, and heart and vascular services.
Duke Nursing Highlights:
- Duke University Health System is designated as a Magnet organization
- Nurses from each hospital are consistently recognized each year as North Carolina's Great 100 Nurses.
- Duke University Health System was awarded the American Board of Nursing Specialties Award for Nursing Certification Advocacy for being strong advocates of specialty nursing certification.
- Duke University Health System has 6000 + registered nurses
- Quality of Life: Living in the Triangle!
- Relocation Assistance (based on eligibility)
Every other weekend 8 hours 5 days a week
Assesses for accuracy in the assignment of patient class (status) to reflect congruence with clinical condition, physician intent, and utilization review outcomes with current rules and regulatory requirements. Supports the medical chart audit process by ensuring accurate, timely, and informative clinical review documentation that supports the medical necessity/level of care. Supports denials management by documenting activities related to denials adjudication according to departmental guidelines and actively works to overturn threatened denial activities. Complies with current rules and regulatory requirements pertaining to utilization management. Initiates actions to obtain appropriate determinations. Collaborates with members of the healthcare team to address, understand, and mitigate excess/avoidable days. Serves as primary source of consultation for issues related to patient class (status) determination.
Work Performed
- Validates authorization for all bedded patients and commercial initiatives. payer authorization within the contractual timeframe at time of presentation, every third day or as needed (e.g. ED, Direct Admit, Transfers).
- Manage concurrent cases to resolution care that may impact payer approval to authorize care as medically necessary.
- Conducts initial review and continued stay reviews as designated in UM plan.
- Reviews records for medical necessity and collaborates with physician (s) and members of the care team to validate information.
- Establishes and communicates estimated LOS and expected discharge date using GMLOS.
- Utilizes an evidenced-based clinical review screening criteria as a guide to support medical necessity determinations and refers cases with failed criteria to the Physician Advisor or appeals as necessary in accordance with the UM plan.
- Facilitates mitigation of denials and peer to peer conversations.
- Collaborates with CM, CSW, Physicians, and Care Team to enhance communication related to discharge planning and utilization management.
- Ongoing collaboration with Case Manager to ensure that patient's condition meets medical necessity criteria and communicate changes that could affect the discharge plan of care.
- Confirms that orders reflect the patient's billing patient status in accordance with the UM plan. Partners with internal Physician Advisors, as well as compliance and revenue cycle partners, within the health system to a safeguard processes and expected outcomes.
- Provides formal and informal education to physicians and the healthcare team to improve processes and outcomes related to utilization review and compliance with utilization management plan.
- Gives feedback as requested to enhance negotiations with payors.
- Develops and maintains positive relationships with customers internal and external to Duke Health System.
- Maintains effective communication with health care team members related to care coordination and utilization management.
- Contributes to a positive working environment and performs other duties as assigned/directed to enhance the overall efforts for the organization.
- Actively participates in a hospital committee.
- Works collaboratively with physicians, staff and service line leadership on quality and performance improvement activities related to optimal utilization of resources, efficient delivery of high quality care, patient flow, capacity management and other clinical cost reduction Utilization Manager Medical Chart Auditor Completes retrospective medical necessity reviews for compliance with regulatory or payor-specific guidelines for all short-stay Medicare inpatients and outpatients (DUH), all observation encounters, all combined/segmental billing encounter questions, and any encounter sent to the UM MCA from PRMO for patient status/post-bill medical necessity denials/coding questions. Reviews and, when appropriate, completes as written appeal for post-bill regulatory agency and Medicare advantage medical necessity audits.
- Provides education and feedback to the Utilization Managers and Providers. ED UM/CM Proactive CM screening and assessment for high-risk, potential readmits, and admitted patient encounters.
- Collaborate with ED treatment team to prevent inappropriate admissions by facilitating community referrals and making post-dc arrangements, as appropriate. Works collaboratively with inpatient case management to support transitions from ED to inpatient.
Knowledge, Skills and Abilities
- Basic computer proficiency required
- Ability to become proficient in the navigation and interpretation of an electronic health record.
- Work effectively in a self-directed role, multi-task, capable of daily problem-solving complex issues.
- Excellent written and verbal skills
- Basic proficiency in the use of Microsoft Word, Power Point and Excel
Level Characteristics
N/A
Minimum Qualifications
Education
BSN required
Experience
Minimum of three years recent acute clinical practice or related health care experience.
Degrees, Licensures, Certifications
Requires Case Management Certification (ACM, CCM or ANCC) within 2 years of hire. BSN required and must have current or compact RN licensure in state of NC. BLS certification required.
Duke is an Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex (including pregnancy and pregnancy related conditions), sexual orientation or military status.
Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas-an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values.
Essential Physical Job Functions:
Certain jobs at Duke University and Duke University Health System may include essential job functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.
What Duke Health employees say
Pay
Benefits
Hours and flexibility
Workplace
Get the full story on Breakroom