Top 30 Quality assurance nurse remote Jobs in North Carolina

Service Access Nurse - Inpatient/Surgery Preservice Verification (100% Remote Position
Duke Health —Durham, NC
- Full-time
- Remote
- Nursing
- Surgery
- RN License
- Relocation assistance
7d
HEDIS Clinical Quality Analyst (Full Time, Remote, North Carolina Based)
Alliance Health —Morrisville, NC
- $79,425 - $101,267 a year
- Full-time
- Remote
- Microsoft Word
- Nursing
- RN License
- Disability insurance
- Health insurance
Remote LPN Customer Care Screener
ACC PREMIERE —Raleigh, NC
- $24 - $26 an hour
- Remote
- RN License
- Computer literacy
- Organizational skills
- Paid training
- Work from home
Quick Apply
Licensed Practical Nurse- Full Time- Day Shift
Raleigh Oaks Behavioral Health —Garner, NC
- 12 hour shift
- CPR Certification
- Nursing
- Psychiatry
Quick Apply
Registered Nurse
GT Independence —Raleigh, NC
- Nursing
- RN License
- Mid-level
- Paid time off
Quick Apply
6d
Registered Nurse
GT Independence —Greensboro, NC
- Nursing
- RN License
- Mid-level
- Paid time off
Quick Apply
6d
Home Care Nurse Supervisor
Home Helpers Home Care —Raleigh, NC
- $35 - $45 an hour
- Full-time
- Hybrid work
- Background check
- Nursing
- 7 years
- 401(k)
- Paid time off
Quick Apply
3d
Nurse Lead (RN)
Always Best Care Senior Services —Burlington, NC
- $83,000 - $84,000 a year
- Full-time
- Nursing
- RN License
- 3 years
- Travel reimbursement
- Paid training
Quick Apply
9d
Clinical Quality Assurance Specialist - Bone Marrow Transplant Program
UNC Health —Chapel Hill, NC
- $35.87 - $51.57 an hour
- Full-time
- Hybrid work
- Nursing
- RN License
- Mid-level
Clinical Manager, Advocacy and Navigation
Well Dot, Inc —Chapel Hill, NC
- $80,000 - $90,000 a year
- Full-time
- RN License
- Licensed Clinical Social Worker
- HIPAA
Quick Apply
12d
Project Manager
Pavion Corp. —Knightdale, NC
- $90,000 - $120,000 a year
- Remote
- Microsoft Excel
- Microsoft Outlook
- Mid-level
Quick Apply
Senior Engineer – Stability Analysis (Remote Eligible-US)
GE Vernova —Wilmington, NC
- $111,200 - $213,200 a year
- Full-time
- Remote
- 5 years
- Engineering
- Pass drug screening
- Paid parental leave
- Paid holidays
Nurse Practitioner, Evenings, Nights and Weekends Per Diem
Chapters Health System, Inc —Raleigh, NC
- $52.50 an hour
- Part-time
- Remote
- Background check
- Nursing
- Microsoft Excel
Quick Apply
2d
Clinician/Therapist – Hybrid Behavioral Health Services
Mind & Mane, LLC —Rocky Mount, NC
- $40 - $70 an hour
- Part-time
- Hybrid work
- Bilingual
- Licensed Clinical Social Worker
- Mid-level
- Professional development assistance
- Flexible schedule
Quick Apply
7d
PROJECT EXECUTIVE – HEALTHCARE TECHNOLOGY (ID# 607)
Volarify —Raleigh, NC
- $150,000 - $180,000 a year
- Full-time
- Construction site
- Mentoring
- Senior level
Quick Apply
Clinical Support Tech I (Days) - GI Surgery & Surgical Oncology Acute Care Unit
UNC Health —Chapel Hill, NC
- $18.12 - $25.51 an hour
- Full-time
- Acute care
- Vital signs
- Surgery
- Paid time off
Clinical Support Tech I - GI Surgery & Surgical Oncology Acute Care Unit
UNC Health —Chapel Hill, NC
- $18.12 - $25.51 an hour
- Full-time
- Acute care
- Vital signs
- Surgery
- Paid time off
Lead I&C (Instrumentation & Controls) Software Test & Tooling Engineer
GE Vernova —Wilmington, NC
- $98,400 - $164,000 a year
- Full-time
- Remote
- Computer Science
- Engineering
- Pass drug screening
- Paid parental leave
- Paid holidays
Clinical Support Tech II - GI Surgery & Surgical Oncology Acute Care Unit
UNC Health —Chapel Hill, NC
- $18.84 - $26.77 an hour
- Full-time
- Acute care
- Surgery
- Hospital
- Paid time off
Physician (Hematology and Oncology Program Manager)
US Veterans Health Administration —Salisbury, NC
- $350,000 - $400,000 a year
- Online Application
- Background check
- Medicine
- Surgery
- Paid holidays
- Loan repayment program

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quality assurance nurse remote jobs near north carolina

Service Access Nurse - Inpatient/Surgery Preservice Verification (100% Remote Position

Duke Health -
Durham, NC

Apply Now

Job Details

Full-time
7 days ago

Benefits

Relocation assistance

Qualifications

Nursing
RN License
Bachelor of Science in Nursing
Bachelor's degree in nursing
Nursing

Full 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.

Patient Revenue Management Organization

Pursue your passion for caring with the Patient Revenue Management Organization, which is the fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions for Duke Health.

Duke Nursing Highlights:

Duke UniversityHealth 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)

Duke University Health System - Patient Revenue Management Office (PRMO) seeks to hire an experienced Service Access Nurse who will embrace our mission of Advancing Health Together.

Job Summary

Manage patient intake process (including patient triage and admissions) for non-critical transfer patients into Duke University Health System from referring hospitals, clinics, and physicians offices, ensuring appropriate level of care and financial screening.

Work Performed

Evaluate appropriate level of patient care, utilizing expert level clinical decision making to determine severity of illness for all elective, urgent and emergent admissions. Requires expert level analysis of patient clinical information and formulation of an accurate assessment of the patient and his/her condition.
Coordinate with patient, physicians, nursing and/or clinical staff when requirements of admission are not met/authorized, requiring facilitation of alternative care arrangements, physician/administrative override, or delay in service.
Responsible for collecting accurate and viable patient insurance information, and escalating all self-pay patients through the appropriate financial screening process (i.e. POMC, Medicaid, CharityCare, patient liability).
Coordinate with physician, nursing and/or clinical staff in determining that the following have all been secured: (1) referral authorizations,(2) prior approval of specific treatments and surgical procedures, and(3) second surgical opinions of specific treatment/surgical procedures.
Analyze clinical and financial information received on proposed admissions for coding accuracy, difficulty in obtaining authorization, and potential for financial issues.
Initiate and facilitate pre-admission and pre-certification authorizations, requiring the detailed evaluation of clinical documentation.
Responsible for ensuring all scheduled surgical cases are reconciled with the appropriate billing system.
Ensure inpatient vs. outpatient scheduling criteria are met in accordance with published payer CPT lists.
Enter detailed documentation of actions and outcomes in applicable billing system.
Health System resource for coding of ICD-9 diagnoses/procedures, CPT-4 procedures, DRG, & APC assignment.
Trainer and preceptor of Pre-Registration staff in ensuring their clinical knowledge needed to fulfill their position responsibilities.
Provide quality assurance reviews of Pre-Registration staff work, ensuring internal controls are met.
Conduct denial appeal follow-up, through analysis of clinical documentation to support level of care provided and secure reimbursement.
Clinical and health care financial resource to PRMO and broader health system membership.
Expert in medical terminology and clinical data interpretation.
Liaison to all hospital and PDC departments and their staff members, including physicians, clinical nurses, Patient Resource Managers, clinic staff and bed control.
Liaison to Patient Service Representatives, Billers, Collectors, internal and external Case Managers/Patient Resource Managers, Social Workers, and Discharge Planners.
Perform other related duties incidental to the work described herein.

Knowledge, Skills and Abilities

Excellent communication skills; written and verbal. Excellent customer service skills, including phone etiquette. Ability to establish good working relationships with associate departments. Working knowledge of ICD-9/CPT-4 coding.

Minimum Qualifications

Education

BSN Required

Experience

3 years of nursing experience

Degrees, Licensures, Certifications

NC or compact state license

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.

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Refine Your Search

quality assurance nurse remote jobs in north carolina

Service Access Nurse - Inpatient/Surgery Preservice Verification (100% Remote Position

HEDIS Clinical Quality Analyst (Full Time, Remote, North Carolina Based)

Remote LPN Customer Care Screener

Licensed Practical Nurse- Full Time- Day Shift

Registered Nurse

Registered Nurse

Home Care Nurse Supervisor

Nurse Lead (RN)

Clinical Quality Assurance Specialist - Bone Marrow Transplant Program

Clinical Manager, Advocacy and Navigation

Project Manager

Senior Engineer – Stability Analysis (Remote Eligible-US)

Nurse Practitioner, Evenings, Nights and Weekends Per Diem

Clinician/Therapist – Hybrid Behavioral Health Services

PROJECT EXECUTIVE – HEALTHCARE TECHNOLOGY (ID# 607)

Clinical Support Tech I (Days) - GI Surgery & Surgical Oncology Acute Care Unit

Clinical Support Tech I - GI Surgery & Surgical Oncology Acute Care Unit

Lead I&C (Instrumentation & Controls) Software Test & Tooling Engineer

Clinical Support Tech II - GI Surgery & Surgical Oncology Acute Care Unit

Physician (Hematology and Oncology Program Manager)

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