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Medical Record Audit Specialist - Behavioral Health

Remote • Posted 5 hours ago • Updated 5 hours ago

Contract W2

1 Year

Occasional Travel Required

Remote

Depends on Experience

Fitment

Dice Job Match Score™

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Job Details

Skills

Certified Medical Coder
CCS
CPC
CPMA
Medical Coding
Audit
Medical Records
ICD-10-CM
CPT
HCPCS
Appeals
Claims Review
Behavioral Health Coding
Mental Health Coding
Indiana Medicaid
CMS Compliance
AHIMA Standards
Microsoft Excel
Microsoft Word
Microsoft Outlook
Critical Thinking
Technical Writing
VLOOKUP
Cerner
Billing
Auditing
ICD-10
Medicaid

Summary

Certified Medical Coder/Medical Record Audit Specialist - Behavioral Health

Location: Fully Remote, with occasional travel to Downtown Indianapolis, IN (expenses covered)

Job Summary:

We are seeking a Certified Medical Coder/Medical Record Audit Specialist with strong Behavioral Health coding experience to support a state Medicaid program engagement. This role focuses on auditing medical records and claims documentation for coding accuracy and compliance, identifying billing and documentation issues, and preparing audit workpapers and reports in alignment with CMS, AHIMA, and Indiana Medicaid standards.

Key Responsibilities

Review medical records and related documentation to assess coding accuracy and compliance with Indiana Health Coverage Programs, CMS, AMA, and other applicable standards and regulations.
Conduct coding and documentation reviews independently and provide preliminary findings to the Lead Reviewer.
Identify potential coding discrepancies, documentation deficiencies, and billing compliance issues.
Maintain detailed workpapers documenting procedures performed, records reviewed, findings identified, and conclusions reached.
Assist with audit responses and appeals as needed.
Ensure all work aligns with state, federal, and national coding and reimbursement guidelines.
Stay current on CPT, HCPCS, ICD-10-CM, and Medicaid coding guidelines, policies, and regulatory updates.
Research Indiana Medicaid rules and maintain internal repositories of bulletins, policies, and procedures.
Adapt quickly to changing priorities, policies, regulatory updates, and review requirements while maintaining accuracy and meeting deadlines.

Required Qualifications:

Active coding certification: CCS (AHIMA), CPC (AAPC), or CPMA (AAPC).
Minimum 2-3 years of hands-on medical coding, claims review, or audit experience
Significant experience coding Behavioral Health, Mental Health, or Psychiatric encounters
Hands-on proficiency with ICD-10-CM, CPT, and HCPCS coding systems
Experience conducting medical record audits, claims reviews, or supporting appeals
Comfortable completing a timed Excel proficiency assessment (sorting, filtering, VLOOKUP, conditional formatting), required by the client prior to submission

Preferred Qualifications

Familiarity with Indiana Medicaid (IHCP) policies and payer guidelines
Knowledge of CMS regulations and AHIMA Standards of Ethical Coding
Experience with Epic, Cerner, 3M Encoder, or similar EHR and encoder platforms
Prior experience specifically supporting Medicaid audit or compliance functions

Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.

Dice Id: 91133125
Position Id: 9062145
Posted 5 hours ago

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