Remote RN Clinical Auditor — Behavioral Health Expert

Zoho; Indianapolis (IN); Remote; USD 75,000 - 110,000; Full time

Job summary

RADcube - A NLogix Company is seeking a Registered Nurse Clinical Auditor with extensive Behavioral Health experience to support medical record reviews and billing compliance audits for the Indiana Health Coverage Programs (IHCP). This remote role includes occasional travel to Downtown Indianapolis, IN (expenses covered).

Responsibilities include evaluating quality of care, reviewing records and program policies, identifying compliance issues, and preparing audit documentation and reports for

Qualifications

• Active RN license, Indiana or compact.
• Extensive Behavioral Health experience (psychiatric units, behavioral health hospitals, substance use disorder treatment, BH utilization review/claims work).
• Auditing experience: medical record audits, compliance audits, chart review, or clinical/quality audits.

Responsibilities

• Review medical records to evaluate provider compliance with IHCP, CMS, AMA, and behavioral health standards.
• Conduct medical record and compliance reviews independently, providing preliminary findings.
• Identify documentation deficiencies and billing compliance issues within BH claims.
• Maintain detailed workpapers documenting procedures, findings, and conclusions.
• Assist with audit responses and appeals as needed.
• Stay current on Indiana Medicaid behavioral health policy and regulatory updates.

Skills

Behavioral Health experience

Auditing experience

Excel proficiency

Education

RN license (Indiana or compact)

Tools

Excel

Job description

RADcube - A NLogix Company is seeking a Registered Nurse Clinical Auditor with extensive Behavioral Health experience to support medical record reviews and billing compliance audits for the Indiana Health Coverage Programs (IHCP). This remote role includes occasional travel to Downtown Indianapolis, IN (expenses covered).

Responsibilities include evaluating quality of care, reviewing records and program policies, identifying compliance issues, and preparing audit documentation and reports for