Medical Record Audit Specialist
# Medical Record Audit Specialist **RADcube** · United States · `Remote` · `Full Time` 💼 **Уровень роли:** `Mid-level` 🕒 **Статус:** *Опубликовано: сегодня* · *Источник: Himalayas (JSON API)* --- ### Top Skills & Match 🎯 **Ключевой стек роли:** `[Medical-Coder]` `[Medical-Records-Auditor]` `[Health-Information-Specialist]` `[Compliance-Auditor]` `[Behavioral-Health-Coding]` `[Medical-Records-Review-Specialist]` `[Medical-Records-Auditing]` `[Medical-Records-Reviewer]` --- ### About the Role This is a remote position. 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 work-papers 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 work-papers 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. Requirements 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. Originally posted on Himalayas
- Medical-Coder
- Medical-Records-Auditor
- Health-Information-Specialist
- Compliance-Auditor
- Behavioral-Health-Coding
- Medical-Records-Review-Specialist
- Medical-Records-Auditing
- Medical-Records-Reviewer
Наблюдалась 2026-10-09, впервые 2026-10-09, источник — Himalayas (JSON API).