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Medical Record Audit Specialist - Behavioral Health

RADcube

Remote • Today

Easy Apply

Contract

Depends on Experience

Audit Support Specialist - Hybrid

VIVA USA INC

Hybrid in Washington, District of Columbia • 7d ago

Easy Apply

Contract

Depends on Experience

RN Clinical Auditor - Behavioral Health

RADcube

Remote • Today

Easy Apply

Contract

Depends on Experience

IT Audit Specialist

Apex Systems

Chicago, Illinois • Today

Easy Apply

Full-time

$68 - $68 per hour

Fraud, Waste, and Abuse (FWA) Medical Record Reviewer

Elite Technical

Hybrid in Elkridge, Maryland • 3d ago

Easy Apply

Contract

40 - 50

Clinical Data Audit Consultant

Centene Corporation

Remote or California • Today

Full-time

USD 33.71 - 60.67 per hour

DATA MANAGEMENT SPECIALIST, BEHAVIORAL THREAT ASSESSMENT

Broward County Public Schools

No location provided • Today

Full-time

USD 65,457.00 - 93,731.00 per year

Records Management Analyst

BryceTech

Washington, District of Columbia • 3d ago

Full-time

Clinical Applications Trainer & Support Specialist (Behavioral Healthcare)

Pacific Consultancy Services

Hybrid in Nashville, Tennessee • Yesterday

Easy Apply

Third Party, Contract

Depends on Experience

Premium Audit Specialist

Markel Corporation

Omaha, Nebraska • 27d ago

Full-time

Cybersecurity Audit & Compliance Specialist

Creative Global Consulting

Remote • 8d ago

Easy Apply

Contract

35 - 38

Medical Claims Auditor (Remote - Texas)

Gainwell Technologies LLC

Remote or Dallas, Texas • Today

Full-time

USD 50,000.00 - 55,000.00 per year

Medical Claims Auditor (Remote - Texas)

Gainwell Technologies LLC

Remote or Austin, Texas • Today

Full-time

USD 50,000.00 - 55,000.00 per year

Medical Claims Auditor (Remote - Texas)

Gainwell Technologies LLC

Remote or Houston, Texas • Today

Full-time

USD 50,000.00 - 55,000.00 per year

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 6 hours ago

Fitment

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RN Clinical Auditor - Behavioral Health

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RN Clinical Auditor - Behavioral HealthLocation: Fully Remote, with occasional travel to Downtown Indianapolis, IN (expenses covered)Job Summary:We are seeking a Registered Nurse Clinical Auditor with extensive Behavioral Health experience to support medical record reviews and billing compliance audits for the Indiana Health Coverage Programs (IHCP). This role evaluates quality of care, reviews medical records and program policies, identifies compliance issues, prepares audit documentation and r

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Authorization Specialist - II

Remote

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2d ago

Immediate need for a talented Authorization Specialist - II. This is a 06+ Months Contract opportunity with long-term potential and is located in Texas (Remote). Please review the job description below and contact me ASAP if you are interested. Job ID:26-25422 Pay Range: $17 - $19/hour. Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location). Key Responsibilities: Authorization Specialist II t

Easy Apply

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$17 - $19

Senior Data Analyst

Remote

•

Today

Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plan clients across the country. Deployed by over 85 health plans, including many of the top 20, and representing more than 270 million lives, Machinify brings together a fully configurable and content-rich, AI-powered platform along with best-in-class expertise. We're constantly reimagining what's possible in our industry, creatin

Full-time

USD 140,000.00 - 170,000.00 per year

CMS Medicaid Certification & Compliance Project Specialist

Remote

•

2d ago

CMS Medicaid Certification & Compliance Project Specialist The Specialist will work closely with Business Leads, Project Teams, matrix managers, vendors, CMS and MITRE teams, and other stakeholders to ensure certification activities are properly coordinated, documented, and completed on schedule. This is a new position created to provide direct support for sensitive state certification processes and high-visibility MES projects. ResponsibilitiesSupport project teams in executing CMS Medicaid cer

Easy Apply

Contract

$50 - $55

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:

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

Dice Id: 91133125
Position Id: 9062145
Posted 6 hours ago

Fitment

Dice Job Match Score™

🔢 Crunching numbers...

Create job alert

Never miss an opportunity! Create an alert based on the job you applied for.

Similar Jobs

RN Clinical Auditor - Behavioral Health

Remote

•

Today

Easy Apply

Contract

Depends on Experience

Authorization Specialist - II

Remote

•

2d ago

Easy Apply

Contract

$17 - $19

Senior Data Analyst

Remote

•

Today

Full-time

USD 140,000.00 - 170,000.00 per year

CMS Medicaid Certification & Compliance Project Specialist

Remote

•

2d ago

Easy Apply

Contract

$50 - $55