Behavioral Health Compliance Auditor

Mental Health Cooperative; Nashville (TN); Presencial; USD 70.000 - 95.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical Insurance/Prescription Drug

Health Savings Account

Dental & Vision Insurance

Life Insurance

Disability

403b Retirement Plan

Calm App for medication and mental健康

Gym membership discounts

Pet Insurance

Paid Time Off

Descripción de la vacante

Mental Health Cooperative is seeking a Compliance Auditor to conduct audits of clinical documentation, billing, and operations, ensuring adherence to CMS, Medicaid, TJC, OIG, TennCare, HIPAA, and MCO requirements. The role identifies regulatory risks, recommends improvements, and supports remediation across the organization.

The position reports to the Director/VP of Compliance, requires a bachelor’s degree in a related field and at least 3 years’ healthcare auditing experience, with preferred

Formación

• Bachelor’s degree required in healthcare or related field.
• Minimum of three (3) years of healthcare auditing or compliance experience.
• Experience in behavioral health or Medicaid auditing preferred.
• Master’s degree preferred.

Responsabilidades

• Conduct audits of clinical documentation, medical records, billing, coding, claims submission, service authorization, and operational processes.
• Evaluate documentation for compliance with CMS, Medicaid, TJC, OIG, TennCare, and MCO requirements.
• Prepare written audit reports detailing findings, risks, and recommendations.
• Collaborate with department leaders to develop corrective action plans and monitor implementation.
• Assist with regulatory surveys, accreditation readiness, and external audits.

Conocimientos

Regulatory knowledge

Data analysis

Audit report writing

Analytical thinking

Attention to detail

Communication skills

Educación

Bachelor's degree in Healthcare Administration / Public Health / Business Administration / Nursing / Social Work / Behavioral Health / Accounting or related field

Master's degree preferred

Herramientas

EHR systems

Microsoft Office

Descripción del empleo

Mental Health Cooperative is seeking a Compliance Auditor to conduct audits of clinical documentation, billing, and operations, ensuring adherence to CMS, Medicaid, TJC, OIG, TennCare, HIPAA, and MCO requirements. The role identifies regulatory risks, recommends improvements, and supports remediation across the organization.

The position reports to the Director/VP of Compliance, requires a bachelor’s degree in a related field and at least 3 years’ healthcare auditing experience, with preferred