Medical Record Audit Specialist

RADcube - A NLogix Company; Indianapolis (IN); Remote; USD 65,000 - 90,000; Full time

Job summary

RADcube is seeking a Certified Medical Coder/Medical Record Audit Specialist with strong Behavioral Health coding experience to support a state Medicaid program engagement. You will audit medical records and claims for coding accuracy and compliance, and prepare audit work-papers aligned with CMS, AHIMA, and Indiana Medicaid standards.

Remote role with occasional travel to Downtown Indianapolis, IN (expenses covered).

Qualifications

• Active coding certification CCS/CPC/CPMA.
• Minimum 2–3 years of medical coding, claims review, or audit experience.
• Significant Behavioral Health coding experience.
• Proficient with ICD-10-CM, CPT and HCPCS.
• Experience auditing medical records and supporting appeals.
• Excel proficiency assessment required by client.

Responsibilities

• Review medical records to assess coding accuracy and compliance with applicable standards.
• Conduct coding and documentation reviews independently; provide preliminary findings.
• Identify coding discrepancies and billing compliance issues.
• Maintain detailed work-papers of procedures, records, findings, and conclusions.
• Assist with audit responses and appeals as needed.
• Ensure work aligns with state, federal, and national guidelines.
• Stay current on CPT, HCPCS, ICD-10-CM and Medicaid coding guidelines.
• Research Indiana Medicaid rules and maintain policy repositories.

Skills

Medical coding

Behavioral Health coding

Auditing

CMS/AHIMA standards

Documentation review

Education

CCS (AHIMA)

CPC (AAPC)

CPMA (AAPC)

Tools

Excel

Epic

Cerner

3M Encoder

ICD-10-CM / CPT / HCPCS

Job description

Founded in 2015, RADcube is a leading technology consulting and software development firm headquartered in Carmel, Indiana. The company specializes in transforming enterprise ideas into real-world innovations by leveraging emerging technologies such as Artificial Intelligence, Blockchain, and Cloud Computing.

With nearly a decade of industry experience, RADcube serves diverse sectors, including healthcare, finance, government, and manufacturing.

Core Service Portfolio

• Digital Transformation and strategy consulting.
• Custom Software Development tailored to specific business needs.
• Advanced Data Analytics and AI-driven platforms.
• Cybersecurity and risk management.

Recognized for its innovation-led culture, RADcube operates RADlabs, an R&D hub focused on high-impact solutions like Responsible AI and Intelligent Automation. The firm is committed to a human-centric approach, ensuring cutting-edge technology delivers measurable business outcomes and long-term success for global clients.

Industry Honors

• 2026 TechPoint Mira Awards Finalist: Named a finalist for Tech Company of the Year, recognizing high-growth pioneers that demonstrate extraordinary leadership.
• Public Sector Excellence: Awarded the Utah NASPO Cloud & Software Solutions Contract, solidifying their role as a trusted partner for large-scale government digital initiatives and more.

Job Description

This is a remote position.

Certified Medical Coder/Medical Record Audit Specialist - Behavioral Health

Location: Fully Remote, with occasional travel to Downtown Indianapolis, IN (expenses covered)

Job Summary

We are seeking a Certified Medical Coder/Medical Record Audit Specialist with strong Behavioral Health coding experience to support a state Medicaid program engagement. This role focuses on auditing medical records and claims documentation for coding accuracy and compliance, identifying billing and documentation issues, and preparing audit work-papers and reports in alignment with CMS, AHIMA, and Indiana Medicaid standards.

Key Responsibilities

• Reviewmedicalrecords and related documentation to assess coding accuracy and compliance with Indiana Health Coverage Programs, CMS, AMA, and other applicable standards and regulations.
• Conduct coding and documentation reviews independently and provide preliminary findings to the Lead Reviewer.
• Identify potential coding discrepancies, documentation deficiencies, and billing compliance issues.
• Maintain detailed work-papers documenting procedures performed, records reviewed, findings identified, and conclusions reached.
• Assist with audit responses and appeals as needed.
• Ensure all work aligns with state, federal, and national coding and reimbursement guidelines.
• Stay current on CPT, HCPCS, ICD-10-CM, and Medicaid coding guidelines, policies, and regulatory updates.
• Research Indiana Medicaid rules and maintain internal repositories of bulletins, policies, and procedures.
• Adapt quickly to changing priorities, policies, regulatory updates, and review requirements while maintaining accuracy and meeting deadlines.

Requirements

Required Qualifications

• Active coding certification: CCS (AHIMA), CPC (AAPC), or CPMA (AAPC).
• Minimum 2-3 years of hands-on medical coding, claims review, or audit experience
• Significant experience coding Behavioral Health, Mental Health, or Psychiatric encounters
• Hands-on proficiency with ICD-10-CM, CPT, and HCPCS coding systems
• Experience conducting medical record audits, claims reviews, or supporting appeals
• Comfortable completing a timed Excel proficiency assessment (sorting, filtering, VLOOKUP, conditional formatting), required by the client prior to submission

Preferred Qualifications

• Familiarity with Indiana Medicaid (IHCP) policies and payer guidelines
• Knowledge of CMS regulations and AHIMA Standards of Ethical Coding
• Experience with Epic, Cerner, 3M Encoder, or similar EHR and encoder platforms
• Prior experience specifically supporting Medicaid audit or compliance functions.