Behavioral Health Audit Specialist

Internationalinsuranceprofessionals; Northern (KY); Hybrid; USD 55,000 - 117,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Retirement savings plan

Paid time off

Job summary

CVS Health is seeking a Behavioral Health Auditor to review medical and behavioral health records for coding and documentation compliance across multiple regulatory standards. You will collaborate with stakeholders, identify deficiencies, and support corrective action plans.

Role requires 5+ years in behavioral health, CPC/CCS/CPMA certification is a plus, and willingness to travel in Louisiana. Master’s degree is required and ongoing professional development is expected.

Qualifications

• Licensed Mental Health Provider in Louisiana in good standing (LPC/LMFT/LCSW/LMSW/APRN).
• Minimum 5 years of professional work experience including behavioral health.
• 3–5 years reviewing and interpreting claims data, medical records, and clinical documentation.
• Knowledge of behavioral health documentation requirements and regulatory standards.
• Proficiency with digital systems and technology applications.
• Ability to handle sensitive information ethically and professionally.
• Must reside in Louisiana and be willing to travel up to 25%.

Responsibilities

• Complete a variety of medical and behavioral health audits.
• Audit provider records for coding and documentation compliance with applicable standards.
• Identify deficiencies and recommend follow-up actions and corrective action plans.
• Support regulatory deliverables and provide provider education and training.
• Maintain audit records and participate in reliability and scoring activities.

Skills

Licensed Mental Health Provider (LA)

5+ years professional experience

Claims data & medical record review

Regulatory knowledge

Effective communication

Digital systems proficiency

Strategic decision making

Education

Master's degree

Tools

EHR systems

Quickbase

Job description

CVS Health is seeking a Behavioral Health Auditor to review medical and behavioral health records for coding and documentation compliance across multiple regulatory standards. You will collaborate with stakeholders, identify deficiencies, and support corrective action plans.

Role requires 5+ years in behavioral health, CPC/CCS/CPMA certification is a plus, and willingness to travel in Louisiana. Master’s degree is required and ongoing professional development is expected.