data reviewer

Oregon Health & Science University

<div>Department Overview:
<div>
The Critical Care Services Clinical Reviewer is the primary clinical reviewer for the ELSO registry as well as the Get With the Guidelines Stroke Registry, with additional abstraction duties as required by manager (i.e. supporting additional stroke abstraction per DNV requirements). Primary site abstraction is for OHSU. Duties include collecting concurrent and retrospective data, assuring integrity of the data collection and data entry for</div><div>
data submittal and data repository, reporting clinical outcomes and descriptive data, and integrating findings into quality improvement activities. The incumbent is responsible for accurate and timely collection and transmission of data in accordance with the guidelines established and performing data queries of that database</div><div>
as requested. The clinical reviewer will stay pro-actively appraised of any definitional, specification, or reporting changes and will actively collaborate with the registry and associated vendors. This position collaborates with the ECMO coordinators, ECMO and neurology faculty and staff, Stroke Program Manager, quality management staff, and other clinical reviewers. They will also participate as a member in applicable best practice and quality committee meetings.</div>
Function/Duties of Position:
<div>
Data Collection and abstraction</div><ul><li>
identifies patients for inclusion in applicable registries</li><li>
navigates the electronic medical record system, Epic, to abstract concurrent and retrospective data on all patients meeting national registry guidelines</li><li>
finds, reads, and comprehends H&amp;Ps, discharge summaries, progress notes, procedure notes, labs, medications, and outside medical records within Epic</li><li>
orders records from outside facilities when necessary in order to complete all the data collection fields</li><li>
collaborates with physicians and patient care teams to determine data needs and evaluate clinical outcomes</li><li>
monitors accuracy of data via automated and auditing means</li><li>
updates data collection tool as appropriate and in accordance with registry definitions, specifications, and guidelines</li><li>
enters accurate and complete data in a timely manner, using the approved software</li><li>
updates database software and data fields as necessary</li><li>
ensures timely data entry and submittal, integrity of data, and implementation of quality control measure to assure accuracy and validity</li><li>
develops and updates standard work tools</li><li>
exports data to registries per guidelines and in accordance with data security and integrity standards</li><li>
develops efficiencies to improve data collection processes</li><li>
works collaboratively to develop processes and ensure timely and complete collection and entry of data</li><li>
identifies issues related to documentation and works with appropriate clinicians and informatics staff to make appropriate improvements</li><li>
identifies issues potentially related to clinical practice and guideline adherence and brings those to the attention of the quality director, service line director, and appropriate medical director</li></ul><div>
Data Reporting and Analysis</div><ul><li>
distributes national benchmarking reports to customers as appropriate and as requested by medical directors, service line directors, and clinical staff</li><li>
develops and provides descriptive, statistical, and comparative analysis and reports of data as requested (analysis and reporting would include narrative, tabular, and graphical documentation and presentation)</li><li>
works closely with physician champion, other clinical staff, supervisor, quality management staff, and hospital staff to identify opportunities for improvement</li><li>
develops and reports standardized queries, reports, and dashboards on a quarterly basis and additional queries as requested</li><li>
prepares and presents comprehensive reports to appropriate committees, management, and other audiences within defined timeframes</li><li>
establishes effective working relationships with medical and service line leadership for reliable and meaningful data interpretation and analysis</li><li>
coordinates data inquiries to promote research activities as requested</li><li>
actively participates in accreditation visits and preparation, and provides clinical outcome and performance improvement data as required</li><li>
prepares presentations / documentation and helps present during survey visits</li><li>
presents data to DNV during onsite and intracycle visits</li></ul><div>
Communication and software maintenance</div><ul><li>
collaborates with appropriate ITG staff to address software related issues and upgrades</li><li>
acts as primary liaison with ELSO and GWTG-Stroke, and any other registries as assigned by manager</li><li>
coordinates discussions with ITG on database-related interfaces
</li><li>communicates openly and effectively with certified software vendors
</li><li>works collaboratively with vendors to troubleshoot any database and software-related issues</li><li>
communicates with database registry staff</li><li>
keeps apprised of applicable changes
</li><li>briefs and updates cardiovascular service line and quality management staff as appropriate</li></ul><div>
Other Duties as Assigned</div>
Required Qualifications:
<ul><li><div>
A Bachelor&rsquo;s degree in finance, business management or related field; AND</div></li><li><div>
Two years of industry related experience that includes project management, financial accounting, management reporting and analysis of specialized work processes standards, regulations; statistics or quantitative analysis methods and procedures, OR</div></li><li><div>
An equivalent combination of education, training and/or experience.</div></li></ul><div>
Job Related Knowledge, Skills and Abilities (Competencies):</div><ul><li>
Experience in hospital department, clinic, patient care unit, clinical research, or medical record reviewer</li><li>
Clinical chart review and abstraction experience or experience in medical database entry
</li><li>Experience working with national registries or databases</li><li>
Proficient computer skills including the use of MS Office products, basic statistical skills, and the internet.
</li><li>Experience with relational databases and data quality methods
</li><li>Clinical knowledge and understanding of patient care.</li><li>
Experience in clinical chart review and abstraction.
</li><li>Excellent verbal and written communication skills.</li><li>
Must be able to perform the essential functions of the position with or without accommodation 
</li></ul>
Preferred Qualifications:
<ul><li>Degree in healthcare related field preferred</li><li>
clinical data collection experience
</li><li>experience with the heart failure patient population</li><li>
Access and Excel proficiency
</li><li>Quality improvement and patient safety knowledge and experience</li><li>
Advanced statistic knowledge and experience</li></ul>
Why apply to OHSU?: We are Oregon's only public academic health center. In addition to caring for patients, we lead groundbreaking research. We also train the next generation of health care professionals. As Portland's largest employer, we give you opportunities to learn and advance in a system of hospitals and clinics across Oregon and Southwest Washington. All are welcome. OHSU welcomes people of all ages, ethnicities, genders, national origins, religions and sexual orientations. We are striving to build an anti-racist, multicultural institution and encourage people with diverse backgrounds to apply. To request reasonable accommodation, contact askhr@ohsu.edu</div>

Critical Care Services Clinical Reviewer (Business Data Analyst 3)

Staffing Solutions Organization LLC

<div>
 
 
 Ensure Quality Care Across Illinois&mdash;One Review at a Time.
 
 
 
 
 
 
 
 Nurse Reviewer &ndash; Illinois
 
 
 
 
 Location:
 
 Remote with on‑site visits across Illinois
 
 
 
 
 
 
 Position Overview
 
 
 
 The Nurse Reviewer conducts provider compliance reviews to ensure adherence to state regulations, quality standards, and program requirements. This role includes conducting onsite visits, evaluating documentation, and determining provider compliance. The Nurse Reviewer works independently, exercises sound judgment, and provides recommendations that guide provider improvement and support statewide oversight efforts.
 
 
 
 
 
 
 Duties &amp; Responsibilities
 
 
 <ul>
 <li>
 Build and maintain effective relationships with providers and users to support high‑quality customer service.
 </li>
 <li>
 Evaluate providers for compliance with applicable state and program regulations.
 </li>
 <li>
 Coordinate and schedule on‑site provider visits; clearly communicate visit requirements.
 </li>
 <li>
 Conduct compliance interviews with providers and gather all necessary information.
 </li>
 <li>
 Review provider documentation, policies, and business practices for regulatory alignment.
 </li>
 <li>
 Collect, organize, and submit documentation supporting compliance findings.
 </li>
 <li>
 Utilize technology and web‑based systems to convert paper documentation to electronic format.
 </li>
 <li>
 Conduct in‑person assessments of provider sites to evaluate compliance with oversight requirements.
 </li>
 <li>
 Summarize on‑site visit findings accurately and professionally.
 </li>
 <li>
 Exercise independent judgment to evaluate compliance and make final determinations based on documented evidence.
 </li>
 <li>
 Identify deficiencies and recommend appropriate next steps to support provider improvement.
 </li>
 <li>
 Analyze trends in non‑compliance and identify gaps in provider business processes.
 </li>
 <li>
 Provide timely recommendations and updates to the Supervisor.
 </li>
 <li>
 Maintain HIPAA standards and confidentiality at all times.
 </li>
 <li>
 Perform other duties as assigned.
 </li>
 </ul>
 
 
 
 
 
 Required Skills
 
 
 <ul>
 <li>
 Strong interpersonal skills with the ability to relate well to staff and providers.
 </li>
 <li>
 Active listening and effective communication skills.
 </li>
 <li>
 Proficiency in MS Word, Excel, Outlook, and web‑based applications.
 </li>
 <li>
 Process‑oriented and results‑driven work approach.
 </li>
 <li>
 Ability to foster teamwork and collaborate across levels of management and staff.
 </li>
 <li>
 Ability to work independently and within a team environment.
 </li>
 <li>
 Excellent written and verbal communication skills and customer‑service techniques.
 </li>
 <li>
 High accuracy, strong attention to detail, and commitment to quality.
 </li>
 <li>
 Proven ability to meet deadlines and follow strict standards.
 </li>
 <li>
 Ability to travel regularly to provider sites across Illinois.
 </li>
 </ul>
 
 
 
 
 
 Qualifications
 
 
 
 
 Education
 
 
 <ul>
 <li>
 Bachelor&rsquo;s degree in any field (Nursing preferred)
 </li>
 </ul>
 
 
 Experience
 
 
 <ul>
 <li>
 Minimum
 
 2 years of clinical experience
 
 working with critical care providers, public health providers, or providers serving children, older adults, individuals with traumatic brain injury, or individuals with developmental disabilities.
 </li>
 <li>
 Minimum
 
 1 year of experience
 
 conducting quality assurance reviews.
 </li>
 </ul>
 
 
 Certification
 
 
 <ul>
 <li>
 Active Illinois Registered Professional Nurse (RN) license required.
 </li>
 </ul>
 
 
 
 
 
 Working Conditions
 
 
 <ul>
 <li>
 Remote work with
 
 2&ndash;3 on‑site provider visits per week
 
 throughout the state of Illinois.
 </li>
 </ul>
 
 
 
 
 
 Benefits (Through SSO)
 
 
 
 SSO offers a competitive benefits package that supports your health, financial well‑being, and long‑term growth, including:
 
 <ul>
 <li>
 Medical, dental, and vision insurance
 </li>
 <li>
 401(k) with discretionary employer match
 </li>
 <li>
 Paid time off and holidays
 </li>
 <li>
 Flexible spending accounts
 </li>
 <li>
 Additional employee perks
 </li>
 </ul>
 
 
 
 
 
 Keyword Search Terms
 
 
 
 Nurse Reviewer, RN Reviewer, Provider Management Specialist, Compliance Nurse, Healthcare Quality Review, Provider Compliance, Medicaid Compliance, Clinical Reviewer, Illinois RN, Site Visit Nurse, Healthcare Auditor, Public Health Nursing, QA Nurse, Provider Monitoring.
 
</div>

Nurse Reviewer

Staffing Solutions Organization LLC (SSO)

Staffing Solutions Organization LLC (SSO), an affiliate of Public Consulting Group LLC (PCG), is focused on delighting clients with world-class managed staffing and talent consulting services. SSO is committed to a diverse workforce, which is a reflection of our clients and the people they serve.
 
Nurse Reviewer – Illinois
 Location: Remote with on site visits across Illinois
 
Position Overview
 The Nurse Reviewer conducts provider compliance reviews to ensure adherence to state regulations, quality standards, and program requirements. This role includes conducting onsite visits, evaluating documentation, and determining provider compliance. The Nurse Reviewer works independently, exercises sound judgment, and provides recommendations that guide provider improvement and support statewide oversight efforts.
 
Duties & Responsibilities
 <ul>
<li>Build and maintain effective relationships with providers and users to support high quality customer service.</li>
<li>Evaluate providers for compliance with applicable state and program regulations.</li>
<li>Coordinate and schedule on site provider visits; clearly communicate visit requirements.</li>
<li>Conduct compliance interviews with providers and gather all necessary information.</li>
<li>Review provider documentation, policies, and business practices for regulatory alignment.</li>
<li>Collect, organize, and submit documentation supporting compliance findings.</li>
<li>Utilize technology and web based systems to convert paper documentation to electronic format.</li>
<li>Conduct in person assessments of provider sites to evaluate compliance with oversight requirements.</li>
<li>Summarize on site visit findings accurately and professionally.</li>
<li>Exercise independent judgment to evaluate compliance and make final determinations based on documented evidence.</li>
<li>Identify deficiencies and recommend appropriate next steps to support provider improvement.</li>
<li>Analyze trends in non compliance and identify gaps in provider business processes.</li>
<li>Provide timely recommendations and updates to the Supervisor.</li>
<li>Maintain HIPAA standards and confidentiality at all times.</li>
<li>Perform other duties as assigned.</li>
</ul>
Required Skills
 <ul>
<li>Strong interpersonal skills with the ability to relate well to staff and providers.</li>
<li>Active listening and effective communication skills.</li>
<li>Proficiency in MS Word, Excel, Outlook, and web based applications.</li>
<li>Process oriented and results driven work approach.</li>
<li>Ability to foster teamwork and collaborate across levels of management and staff.</li>
<li>Ability to work independently and within a team environment.</li>
<li>Excellent written and verbal communication skills and customer service techniques.</li>
<li>High accuracy, strong attention to detail, and commitment to quality.</li>
<li>Proven ability to meet deadlines and follow strict standards.</li>
<li>Ability to travel regularly to provider sites across Illinois.</li>
</ul>
Qualifications
 Education
 <ul>
<li>Bachelor’s degree in any field (Nursing preferred)</li>
</ul>
Experience
 <ul>
<li>Minimum 2 years of clinical experience working with critical care providers, public health providers, or providers serving children, older adults, individuals with traumatic brain injury, or individuals with developmental disabilities.</li>
<li>Minimum 1 year of experience conducting quality assurance reviews.</li>
</ul>
Certification
 <ul>
<li>Active Illinois Registered Professional Nurse (RN) license required.</li>
</ul>
Working Conditions
 <ul>
<li>Remote work with 2–3 on site provider visits per week throughout the state of Illinois.</li>
</ul>
Benefits (Through SSO)
 SSO offers a competitive benefits package that supports your health, financial well being, and long term growth, including:
 <ul>
<li>Medical, dental, and vision insurance</li>
<li>401(k) with discretionary employer match</li>
<li>Paid time off and holidays</li>
<li>Flexible spending accounts</li>
<li>Additional employee perks</li>
</ul>
Keyword Search Terms
 Nurse Reviewer, RN Reviewer, Provider Management Specialist, Compliance Nurse, Healthcare Quality Review, Provider Compliance, Medicaid Compliance, Clinical Reviewer, Illinois RN, Site Visit Nurse, Healthcare Auditor, Public Health Nursing, QA Nurse, Provider Monitoring.
 
Compensation for roles at Staffing Solutions Organization LLC (SSO) varies depending on a wide array of factors including, but not limited to, the specific office location, role, skill set, and level of experience. As required by applicable law, SSO provides a reasonable range of compensation for this role. In addition, SSO provides a range of benefits for this role.
 
Applicants must be authorized to work in the U.S. This position is not eligible for work authorization sponsorship (including H-1B sponsorship) by SSO and under the federal laws relating to the F-1 STEM EAD program, this position is not eligible to support a STEM EAD extension application.
 
All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity, marital status, age, national origin, protected veteran status, or disability. Staffing Solutions Organization LLC is an E-Verify participant.

Liberty Healthcare Corporation

<div>Registered Nurses are encouraged to consider a full-time Clinical Reviewer position with Liberty Healthcare.

As a Clinical Reviewer, you will be an active contributor with a large-scale program which endeavors to enrich the lives of older adults and people who are living with developmental disabilities.

Your role will focus on the review and analysis of health information of recipients of Medicaid HCBS waiver services, and your day-to-day responsibilities will include:
<ul>
<li>Reviewing medical records and personal health information</li>
</ul><ul><li>Conducting root cause analyses of critical incidents and deaths</li>
</ul><ul><li>Forming objective evidence-based opinions</li>
</ul><ul><li>Writing detailed reports</li>
</ul><ul><li>Leading and participating in committee and team meetings</li>
</ul><ul><li>Providing technical assistance and training</li>
</ul><ul><li>Collaborating with stakeholders</li>
</ul>
This is a remote-first position which will primarily allow you to work in your home office with an occasional need to attend in-person meetings in Nebraska. This is a non-direct care role which does not involve patient contact or nursing care.

As a valued full-time employee of Liberty Healthcare and Clinical Reviewer, you can expect:
<ul>
<li>$80,000 annual salary</li>
</ul><ul><li>Health insurance, dental insurance, vision insurance, life insurance, and disability insurance</li>
</ul><ul><li>30 days of paid time off each year for holidays, vacation, sick leave, and personal days</li>
</ul><ul><li>Health Savings Account, 401k plan, and other perks</li>
</ul>
Full details on Liberty's benefits plan are available at www.libertyhealthcare.com/upload/138.pdf
You are a good fit for this position if you possess the following:
<ul>
<li>Professionally licensed as a Registered Nurse in Nebraska</li>
</ul><ul><li>Experience providing nursing services to older adults and people who are living with developmental disabilities</li>
</ul><ul><li>Knowledge of quality assurance methodologies
</li></ul><ul><li>Outstanding analytical and report writing skills</li>
</ul><ul><li>Nebraska residency</li>
</ul>
Liberty Healthcare is an equal opportunity employer committed to diversity, equity, and inclusion. Our organization is composed of, and proudly serves, people of diverse backgrounds and abilities.

Click &ldquo;Apply&rdquo; and submit your resume for immediate consideration.</div>

Registered Nurse – Clinical Reviewer

Medical City Healthcare

<div><h5 class="jobSectionHeader">Introduction</h5>
Are you passionate about the patient experience? At HCA Healthcare, we are committed to caring for patients with purpose and integrity. We care like family! Jump-start your career as an Inpatient Coding Quality Audit Reviewer today with Parallon.
This is a work from home position!
Schedule: Monday-Friday Day Shift!<h5 class="jobSectionHeader">
Benefits</h5>
Parallon offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:<ul><li>
Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.</li><li>
Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.</li><li>
Free counseling services and resources for emotional, physical and financial wellbeing 
</li><li>
401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service) 
</li><li>
Employee Stock Purchase Plan with 10% off HCA Healthcare stock 
</li><li>
Family support through fertility and family building benefits with Progyny and adoption assistance. 
</li><li>
Referral services for child, elder and pet care, home and auto repair, event planning and more 
</li><li>
Consumer discounts through Abenity and Consumer Discounts 
</li><li>
Retirement readiness, rollover assistance services and preferred banking partnerships 
</li><li>
Education assistance (tuition, student loan, certification support, dependent scholarships) 
</li><li>
Colleague recognition program 
</li><li>
Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence) 
</li><li>
Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.</li></ul> 
Learn more about Employee Benefits
Note: Eligibility for benefits may vary by location. 
Come join our team as an Inpatient Coding Quality Audit Reviewer. We care for our community! Just last year, HCA Healthcare and our colleagues donated $13.8 million dollars to charitable organizations. Apply Today!<h5 class="jobSectionHeader">
Job Summary and Qualifications</h5>
As a work from home Inpatient Coding Auditor, you will be responsible for performing internal quality assessment reviews on Health Information Management Service Center (HSC) coders to ensure compliance with national coding guidelines, the HSC coding policies and the Company coding policies for complete, accurate and consistent coding which result in appropriate reimbursement and data integrity. You will review outcomes are communicated to the HSC team to improve the accuracy, integrity and quality of patient data, to ensure minimal variation in coding practices and to improve the quality of physician documentation within the body of the medical record to support code assignments.
What you will do in this role:
<ul><li>Leads, coordinates and performs all functions of quality reviews (routine, pre-bill, policy driven and incentive plan driven) for inpatient and/or outpatient coding across multiple HSCs</li><li>
Assists in ensuring HSC coding staff adherence with coding guidelines and policy</li><li>
Demonstrates and applies expert level knowledge of medical coding practices and concepts</li><li>
Participates on special reviews or projects</li><li>
Maintains or exceeds 95% productivity standards</li><li>
Maintains or exceeds 95% accuracy</li><li>
Meets all educational requirements as stated in current Company policy</li><li>
Reviews all official data quality standards, coding guidelines, Company policies and procedures, and clinical/medical resources to assure coding knowledge and skills remain current
</li></ul>What qualifications you will need:<ul><li>
High school diploma and/or GED preferred</li><li>
Undergraduate degree in HIM/HIT preferred</li><li>
Minimum of 3 years acute care inpatient/outpatient coding experience preferred</li><li>
Minimum of 3 years coding auditing/monitoring experience strongly preferred</li><li>
RHIA, RHIT and/or CCS preferred</li><li>
Please visit our Parallon HCA Healthcare Coding Landing Page for more information on Coding Opportunities.
</li></ul>CLICK HERE for more information on Parallon HCA Coding
&quot;
Parallon provides full-service revenue cycle management, or total patient account resolution, for HCA Healthcare. Our services include scheduling, registration, insurance verification, hospital billing, revenue integrity, collections, payment compliance, credentialing, health information management, customer service, payroll and physician billing. We also provide full-service revenue cycle management as well as targeted solutions, such as Medicaid Eligibility, for external clients across the country. Parallon has over 17,000 colleagues, and serves close to 1,000 hospitals and 3,000 physician practices, all making an impact on patients, providers and their communities.
HCA Healthcare has been recognized as one of the World&rsquo;s Most Ethical Companies&reg; by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.
&quot; 
&quot;The great hospitals will always put the patient and the patient's family first, and the really great institutions will provide care with warmth, compassion, and dignity for the individual.&quot;- Dr. Thomas Frist, Sr. 
HCA Healthcare Co-Founder
If you are looking for an opportunity that provides satisfaction and personal growth, we encourage you to apply for our Coding Quality Audit Reviewer opening. We promptly review all applications. Highly qualified candidates will be contacted for interviews. Unlock the possibilities and apply today!
We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.</div>

Inpatient Coding Quality Audit Reviewer

HCA Florida Capital Hospital

Search 10000+ Data reviewer jobs near you this April. New roles added regularly across leading industries. Apply today.

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