Behavioral Health Compliance Specialist

Pennsylvania Psychological Association; Louisiana, United States, Northern America, Americas; Hybrid; USD 54,000 - 117,000; Full time

Job summary

CVS Health is seeking a Behavioral Health Auditor to review medical and behavioral health records for coding accuracy and documentation compliance with state and federal standards. You will conduct provider audits, identify deficiencies, and support corrective action plans.

The role collaborates with internal partners, offers professional development, requires licensure in Louisiana, 5+ years of behavioral health experience, CPC/CCS/CPMA certification, and willingness to travel up to 25% across

Qualifications

• Licensed mental health provider in good standing (LA).
• 5+ years of professional experience in behavioral health.
• 3–5 years reviewing claims data, medical records, and clinical documentation.
• Knowledge of regulatory standards and documentation requirements.
• Proficient with digital systems and analytics tools.

Responsibilities

• Conduct medical and behavioral health audits to assess coding and documentation.
• Ensure records comply with regulatory, contractual and organizational standards.
• Identify deficiencies and recommend corrective action plans for providers.
• Assist with education, training, and outreach to providers.

Skills

Licensed Mental Health Provider

Regulatory knowledge

Review claims data

Auditing experience

Communication skills

Proficiency with digital systems

Travel willingness

Education

Master's degree

Tools

Quickbase

EHR systems

Job description

CVS Health is seeking a Behavioral Health Auditor to review medical and behavioral health records for coding accuracy and documentation compliance with state and federal standards. You will conduct provider audits, identify deficiencies, and support corrective action plans.

The role collaborates with internal partners, offers professional development, requires licensure in Louisiana, 5+ years of behavioral health experience, CPC/CCS/CPMA certification, and willingness to travel up to 25% across