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RN Clinical Auditor - Behavioral Health

RADcube

Remote • 9d ago

Easy Apply

Contract

Depends on Experience

Behavioral Health Clinical Case Manager- Eastern Mountain Region

CVS Health

Pikeville, Kentucky • Today

Full-time

Compensation information provided in the description

Behavioral Health Clinical Case Manager- Eastern Mountain Region

CVS Health

Frankfort, Kentucky • Today

Full-time

Compensation information provided in the description

Behavioral Health Clinical Case Manager- Eastern Mountain Region

CVS Health

Hazard, Kentucky • Today

Full-time

Compensation information provided in the description

Senior Clinical Research Associate

EmployVision

Remote • Today

Easy Apply

Contract

$70 - $80

Clinical Assessor

InfiCare

Raleigh, North Carolina • 5d ago

Easy Apply

Third Party, Contract

Depends on Experience

Senior Associate Director Clinical Development Trial Lead - Remote / Telecommute

Cynet Systems

Indianapolis, Indiana • Yesterday

Easy Apply

Third Party, Contract

Depends on Experience

Veeva Clinical SME – Techno-Functional

Boston Technology Corporation

Remote • Today

Easy Apply

Contract

60 - 70

Project Manager (Clinical-Payer)

Vish Consulting Services, Inc.

Hybrid in Dallas, Texas • 12d ago

Easy Apply

Contract

Depends on Experience

Clinical Trial Product Owner

IRIS Software, Inc.

Remote • 20d ago

Easy Apply

Full-time

Depends on Experience

Analyst - Clinical Applications: IV

Randstad Digital

Tampa, Florida • Today

Contract

USD33 - USD43

Clinical Delivery Leader / Scrum Master - Remote

Cyber Sphere LLC

Remote • Yesterday

Easy Apply

Third Party, Contract

Depends on Experience

Clinical Research Coordinator - Hybrid

VIVA USA INC

Hybrid in Stanford, California • 8d ago

Easy Apply

Contract

46 - 51

CLINICAL RESEARCH ASSOCIATE

Galaxy Infotech INC

Hybrid in Cypress, California • Today

Easy Apply

Contract

60+

Clinical Vendor Governance Program Manager

Whiz Global LLC

Remote • 15d ago

Easy Apply

Contract

Depends on Experience

CTO Clinical Research Coordinator - Senior (Mays Cancer Center)

The UT Health Science Center at San Antonio

San Antonio, Texas • Today

Full-time

Clinical Social Worker

Calsoft Labs

Cambridge, Massachusetts • 21d ago

Easy Apply

Contract

60 - 65

Clinical Services Project Manager I

Motion Recruitment Partners, LLC

Remote • Today

Easy Apply

Contract

$35 - $35

Clinical BSA/QA

Shakti Solutions

Remote • 2d ago

Easy Apply

Contract

Depends on Experience

Business Analyst - Clinical Data & TFL Submission Package

Midasis Technologies LLC

Remote • 2d ago

Easy Apply

Contract

Depends on Experience

Epic Clinical Documentation Application Analyst ** 100% Remote **

Amerit Consulting

Remote • 2d ago

Easy Apply

Contract

90 - 110

Business Analyst (Clinical Operations)

Arnex Solutions LLC

Cambridge, Massachusetts • Today

Full-time, Third Party

Depends on Experience

Sr. Project Manager - Clinical Research

Software Guidance & Assistance

Los Angeles, California • Today

Contract

USD 50.00 - 65.00 per hour

Clinical Business Analyst (for SDTM Automation)

Spotline

Remote • Today

Easy Apply

Third Party, Contract

Depends on Experience

Clinical Trials Payment Coordinator/Site Payment Coordinator (Remote)

Talent Software Services, Inc

Rahway, New Jersey • 6d ago

Easy Apply

Third Party, Contract

$28 - $30

Director Clinical Pharmacology

CSL

King of Prussia, Pennsylvania • Today

Full-time

Clinical Pharmacist - Remote

VIVA USA INC

Remote • 8d ago

Easy Apply

Contract

52 - 57

Clinical Data Associate

HR Solutions

Remote • 23d ago

Full-time

70000 - 85000

Clinical Operation Project Manager

Sapience, Inc

Remote • Yesterday

Easy Apply

Contract

Depends on Experience

Senior RAVE Clinical Database Programmer

Katalyst Healthcares and Lifesciences

Remote or New Jersey • 2d ago

Full-time

Job Details

Skills

Auditing
Documentation
Billing
ICD-10
Medical Records
Quality Audit
VLOOKUP
Health Care
Microsoft Excel
Medicaid
Medical record audits
Chart Review
Medicaid Claims

Summary

RN Clinical Auditor - Behavioral Health

Location: 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 reports, and supports appeals activities within behavioral health, psychiatric, and substance use disorder treatment settings.

Key Responsibilities:

Review medical records and documentation to evaluate provider compliance with IHCP, CMS, AMA, and behavioral health-specific standards
Conduct medical record and compliance reviews independently, providing preliminary findings to the Lead Reviewer
Identify documentation deficiencies and billing compliance issues within psychiatric/BH claims
Maintain detailed workpapers documenting procedures, findings, and conclusions
Assist with audit responses and appeals as needed
Stay current on Indiana Medicaid behavioral health policy and regulatory updates

Required Qualifications:

Active RN license, Indiana or compact
Extensive Behavioral Health experience (psychiatric units, behavioral health hospitals, substance use disorder treatment, BH utilization review/claims work)
Auditing experience: medical record audits, compliance audits, chart review, or clinical/quality audits.
2+ year of Medicaid claims review, billing compliance, or healthcare reimbursement experience
Comfortable completing a timed Excel proficiency assessment (sorting, filtering, VLOOKUP, conditional formatting), required by the client prior to submission.

Preferred Qualifications:

CCS or CPC coding certification
Indiana Medicaid (IHCP) program familiarity
Knowledge of CPT and ICD-10 coding
Experience with ASAM criteria, InterQual, or MCG guidelines for behavioral health level-of-care determinations
Fraud, waste, and abuse (FWA) exposure

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: 9089867
Posted 30+ days ago

Fitment

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Certified Medical Coder/Medical Record Audit Specialist - Behavioral HealthLocation: Fully Remote, with occasional travel to Downtown Indianapolis, IN (expenses covered)Job Summary:We are seeking aCertified Medical Coder/Medical Record Audit Specialistwith strongBehavioral Healthcoding 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, a

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JOB DESCRIPTION Potential for conversion The Impact you will have The Risk Adjustment Coding Auditor ensures the accuracy and completeness of coded clinical data to support compliant reporting and appropriate reimbursement across risk adjustment programs. The role strengthens organizational performance by identifying coding and documentation gaps, mitigating financial and regulatory risk, and improving data integrity. It provides subject matter expertise to support consistent application of codi

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Epic Analyst

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Position: Epic Application Analyst Location: South San Francisco, CA (Mostly remote/some in-person will be required) Contract: 7+ Months and Extendable Client: San Mateo County Description: Epic-certified behavioral health analyst assigned to HIT BHRS for Project Mosaic, reporting to the HIT BHRS Manager and working with the CTG lead. Scope is the full BHRS behavioral health build across outpatient, crisis, residential, inpatient and SUD programs: documentation (navigators, SmartForms, flowshee

Easy Apply

Third Party, Contract

100 - 110

Job Details

Skills

Auditing
Documentation
Billing
ICD-10
Medical Records
Quality Audit
VLOOKUP
Health Care
Microsoft Excel
Medicaid
Medical record audits
Chart Review
Medicaid Claims

Summary

RN Clinical Auditor - Behavioral Health

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

Job Summary:

Key Responsibilities:

Review medical records and documentation to evaluate provider compliance with IHCP, CMS, AMA, and behavioral health-specific standards
Conduct medical record and compliance reviews independently, providing preliminary findings to the Lead Reviewer
Identify documentation deficiencies and billing compliance issues within psychiatric/BH claims
Maintain detailed workpapers documenting procedures, findings, and conclusions
Assist with audit responses and appeals as needed
Stay current on Indiana Medicaid behavioral health policy and regulatory updates

Required Qualifications:

Active RN license, Indiana or compact
Extensive Behavioral Health experience (psychiatric units, behavioral health hospitals, substance use disorder treatment, BH utilization review/claims work)
Auditing experience: medical record audits, compliance audits, chart review, or clinical/quality audits.
2+ year of Medicaid claims review, billing compliance, or healthcare reimbursement experience
Comfortable completing a timed Excel proficiency assessment (sorting, filtering, VLOOKUP, conditional formatting), required by the client prior to submission.

Preferred Qualifications:

CCS or CPC coding certification
Indiana Medicaid (IHCP) program familiarity
Knowledge of CPT and ICD-10 coding
Experience with ASAM criteria, InterQual, or MCG guidelines for behavioral health level-of-care determinations
Fraud, waste, and abuse (FWA) exposure

Dice Id: 91133125
Position Id: 9089867
Posted 30+ days ago

Fitment

Dice Job Match Score™

To see how well you match this job, please log in or create an account.

Once logged in, be sure to complete your profile to get the most accurate match score.

Create job alert

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

Similar Jobs

Certified Medical Coder/Auditor

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Clinical Coordinator

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