Remote RN Medicaid Behavioral Health Auditor

RADcube - A NLogix Company; Indianapolis (IN); Remote; USD 85,000 - 115,000; Full time

Job summary

RADcube - A NLogix Company is seeking an experienced RN Clinical Auditor with extensive Behavioral Health expertise for a fully remote role. The position includes occasional travel to Downtown Indianapolis, IN (expenses covered) to support Indiana Health Coverage Programs audits and policy reviews.

You will review records, ensure IHCP, CMS, and BH standards are met, and document findings for billing compliance and quality improvement in behavioral health, psychiatric, and substance use disorder

Qualifications

• Active RN license, Indiana or compact.

Responsibilities

• Review medical records and documentation to evaluate provider compliance with IHCP, CMS, AMA, and behavioral health standards.
• Conduct medical record and compliance reviews independently, providing preliminary findings to the Lead Reviewer.
• Identify documentation deficiencies and billing compliance issues within psychiatric/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

RN license

Behavioral health

Auditing

Medicaid claims review

Excel

Job description

RADcube - A NLogix Company is seeking an experienced RN Clinical Auditor with extensive Behavioral Health expertise for a fully remote role. The position includes occasional travel to Downtown Indianapolis, IN (expenses covered) to support Indiana Health Coverage Programs audits and policy reviews.

You will review records, ensure IHCP, CMS, and BH standards are met, and document findings for billing compliance and quality improvement in behavioral health, psychiatric, and substance use disorder