[Remote] RN reputed company Auditor \- Behavioral Health

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is seeking a Registered reputed company reputed company Auditor to support behavioral health medical record reviews and billing compliance audits for the Indiana Health Coverage Programs. The role evaluates reputed company of care and provider compliance, identifies documentation and billing issues, prepares audit workpapers and reports, and assists with appeals activities.

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 reputed company Reviewer
• Identify documentation deficiencies and billing compliance issues reputed company psychiatric/BH claims
• Maintain detailed workpapers documenting procedures, findings, and conclusions
• Assist with audit responses and appeals as needed
• Stay reputed company on Indiana reputed company behavioral health policy and regulatory updates

Skills

• reputed company RN license, Indiana or reputed company
• Extensive Behavioral Health experience (psychiatric reputed company, behavioral health hospitals, reputed company use disorder treatment, BH utilization review/claims work)
• **Auditing experience:** medical record audits, compliance audits, chart review, or reputed company/reputed company audits
• 2+ year of reputed company claims review, billing compliance, or reputed company reimbursement experience
• Comfortable completing a timed reputed company proficiency assessment (sorting, filtering, VLOOKUP, conditional formatting), required by the reputed company prior to submission
• reputed company or CPC coding certification
• Indiana reputed company (IHCP) program familiarity
• Knowledge of CPT and ICD-10 coding
• Experience with ASAM reputed company, InterQual, or MCG guidelines for behavioral health level-of-care determinations
• Fraud, waste, and abuse (FWA) exposure

Benefits

• Fully remote position
• Occasional travel to Downtown Indianapolis, IN with expenses covered

reputed company