Remote Healthcare Audit & Compliance Specialist

Tri-County Human Services; Lakeland (FL); Hybrid; USD 55,000 - 75,000; Full time

Job summary

Tri-County Human Services seeks a billing/audit professional to review service documentation, ensure proper Medicaid and private insurance billing, and support compliance with agency policies. The role requires auditing electronic records, coordinating with staff, and providing guidance to improve documentation for billing opportunities.

Ideal candidates hold a related bachelor’s degree (master’s preferred) and licensure (LCSW/LMHC) is a plus, with 2+ years’ experience in a clinical or billing

Qualifications

• Bachelor’s degree in behavioral health or related field is required.
• Master’s degree and a license (LCSW/LMHC) are preferred.
• 2+ years full-time experience in a setting with Medicaid/private insurance knowledge is expected.

Responsibilities

• Reviews service documentation to determine utilization and quality management.
• Enters audit results into the EHR system for tracking and analysis.
• Coordinates with staff to bill Medicaid, private insurance, and public programs in compliance with policy.
• Identifies billable services not meeting documentation requirements and advises on needed documentation.

Skills

Medicaid billing

Audit

EHR systems

Documentation

Billing compliance

Education

Bachelor's degree in behavioral health

Master's degree preferred

LCSW/LMHC license preferred

Tools

Electronic Health Record (EHR) software

Job description

Tri-County Human Services seeks a billing/audit professional to review service documentation, ensure proper Medicaid and private insurance billing, and support compliance with agency policies. The role requires auditing electronic records, coordinating with staff, and providing guidance to improve documentation for billing opportunities.

Ideal candidates hold a related bachelor’s degree (master’s preferred) and licensure (LCSW/LMHC) is a plus, with 2+ years’ experience in a clinical or billing