Behavioral Health Auditor III

This is a fully remote position, open to applicants in United States.

📋 Description

• Conduct audits and reviews of Behavioral Health claims to detect possible errors.

• Evaluate data in accordance with payer policies, procedures, and regulatory standards.

• Clearly and professionally document findings to support subsequent actions.

• Suggest adjustments or recoveries for claims when necessary.

• Work collaboratively with cross-functional teams to resolve issues and enhance processes.

• Stay informed about changes in regulations, laws, and industry standards.

• Monitor and report audit findings, identifying trends and opportunities.

• Provide your expert knowledge to assist teams with Behavioral Health payment integrity challenges.

• Achieve EXL’s productivity and quality targets while ensuring compliance with HIPAA and other regulations.

⛳️ Requirements

• Education: Bachelor’s degree in healthcare administration, business, finance, or a similar field.

• Experience: 3+ years in Behavioral Health services, including mental health and substance use disorder treatment.

• Credentials (Preferred): CCS, RHIA, RHIT, CPC, RN, MSW – having multiple credentials is a plus!

• Expertise: In-depth knowledge of Behavioral Health standards, payer policies, and regulations.

• Bonus: Experience in auditing for retrospective overpayments in Behavioral Health.

• Capability to work independently in a fully remote setting.

• Strong skills in time management and prioritization.

• A proactive problem-solving attitude and accountability for results.

• Outstanding communication skills, both written and verbal.

• Sharp analytical abilities and meticulous attention to detail.

• Proficient in Microsoft Excel, Word, and OneNote.

• A strong passion for Behavioral Health auditing and a commitment to thriving in a culture of teamwork, collaboration, and excellence.

🏝️ Benefits

• Up to 10% annual travel for team meetings and limited client onsite engagements

• Health insurance

• Professional development opportunities as detailed on the careers page