Behavioral Health Compliance & Audit Specialist

Chimes International LTD; Baltimore (MD); On-site; USD 63,000 - 77,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

Tuition Reimbursement

401(k) Match

Paid Time Off

Life Insurance

Disability Insurance

Employee Recognition

Job summary

Chimes is seeking a Behavioral Health Specialist to join our Compliance team in Maryland. You will help ensure programs meet regulatory standards, maintain accurate clinical documentation, and provide quality services to individuals with intellectual and developmental disabilities.

This full-time role requires CPC or CPC-A certification and at least four years of professional experience in behavioral health, healthcare compliance, or quality assurance. Travel to agency locations is required.

Qualifications

• Active CPC or CPC-A Medical Coding Certification.
• Minimum of four (4) years of professional experience in behavioral health, healthcare compliance, quality assurance, clinical documentation, auditing, or related field.
• Knowledge of behavioral health documentation, regulatory requirements, and compliance practices.
• Familiarity with CPT, revenue, and diagnostic coding.
• Strong analytical, investigative, organizational, and problem-solving skills.
• Excellent written and verbal communication skills.
• Proficiency in Microsoft Office, particularly Word and Excel.
• Ability to travel between agency locations as needed.

Responsibilities

• Conduct scheduled and unannounced audits of programs, clinical records, documentation, and compliance activities.
• Review behavioral health and clinical documentation for accuracy, completeness, and regulatory compliance.
• Monitor compliance with psychological, nursing, behavioral health, and other required clinical services.
• Assist with investigations, identify compliance concerns, and recommend corrective actions.
• Develop and monitor Plans of Correction resulting from audits, investigations, and regulatory reviews.
• Review clinical records, claims, CPT codes, and billing documentation to identify potential compliance issues.
• Evaluate applicable Medicare, Medicaid, and commercial insurance requirements.
• Prepare audit reports, compliance findings, and recommendations for leadership.
• Provide guidance and training to staff regarding documentation, regulatory requirements, and quality improvement.
• Collaborate with program leadership and travel to agency locations for audits, investigations, and site visits.

Skills

CPC/CPC-A

Analytical skills

Regulatory knowledge

Documentation accuracy

MS Office

Education

Bachelor's in Behavioral Health

Tools

Microsoft Word

Microsoft Excel

Job description

Chimes is seeking a Behavioral Health Specialist to join our Compliance team in Maryland. You will help ensure programs meet regulatory standards, maintain accurate clinical documentation, and provide quality services to individuals with intellectual and developmental disabilities.

This full-time role requires CPC or CPC-A certification and at least four years of professional experience in behavioral health, healthcare compliance, or quality assurance. Travel to agency locations is required.