Behavioral Health Compliance Specialist

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

Benefits offered by this job

Medical, Dental, and Vision Insurance

Tuition Reimbursement Options

Flexible Spending Accounts (Health, Dn

Dependent, and Transportation

Life Insurance

Disability Insurance

Paid Time Off

403(b) Retirement Plan with Employer M

Employee Recognition Programs

Employee Referral Bonus Opportunities

Job summary

Chimes | Compliance and Quality Assurance in Baltimore, MD seeks a Behavioral Health Specialist to support regulatory compliance, quality assurance, and accurate clinical documentation across programs.

The role requires CPC or CPC-A certification, at least four years in behavioral health or healthcare compliance, and strong analytical skills. Occasional travel to agency locations is expected as part of audits and site visits.

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 a 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

Medical coding

Auditing

Regulatory compliance

Documentation

Analytical thinking

Education

Bachelor's degree in Behavioral Health or related field

Tools

Microsoft Word

Microsoft Excel

Job description

Chimes | Compliance and Quality Assurance in Baltimore, MD seeks a Behavioral Health Specialist to support regulatory compliance, quality assurance, and accurate clinical documentation across programs.

The role requires CPC or CPC-A certification, at least four years in behavioral health or healthcare compliance, and strong analytical skills. Occasional travel to agency locations is expected as part of audits and site visits.