Internal Auditor

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

📋 Description

• Analyze service documentation and offer technical support and expertise concerning private insurance, ADM, CFBHN, and Medicaid.

• Evaluate randomly selected electronic health records to assess effective utilization and the quality management of services.

• Input audit findings into the electronic health record system for monitoring and analysis purposes.

• Collaborate with staff responsible for documentation and data entry to facilitate billing processes and ensure adherence to agency policies.

• Examine clinical records to pinpoint billable services that do not comply with insurance documentation standards.

• Counsel Program Supervisors and unit personnel on billing opportunities, missed opportunities, and necessary documentation.

• Communicate audit results to facility supervisors and administrative staff, ensuring follow-up on any required corrections.

• Keep abreast of Medicaid, PPWDC, TANF, FIS, CFBHN, and private insurance documentation and billing standards.

• Deliver ongoing training to staff regarding documentation standards and guidelines.

• Instruct assigned support staff on billing and audit processes.

• Propose follow-up measures, including potential disciplinary actions, in consultation with the Compliance Director.

• Assist the compliance department in reviewing, developing, and updating policies and procedures.

• Carry out other assigned responsibilities.

⛳️ Requirements

• A Bachelor's degree in behavioral health or a related field is required.

• A Master's degree is preferred.

• An LCSW or LMHC license is preferred.

• Proficient computer operation skills.

• Familiarity with Medicaid/private insurance, clinical documentation, and billing processes.

• Excellent organizational abilities.

• A minimum of two (2) years of full-time experience in a relevant setting where applicable knowledge and skills were utilized.

• Ability to monitor quality documentation and service utilization trends.

🏝️ Benefits

• Short- and long-term telecommuting in accordance with policy 100.027 – Telecommuting Guidelines.

• Participation in workshops and/or consultations with designated administrative staff to maintain billing and documentation expertise.