RN Clinical Auditor - Behavioral Health

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

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. Their core service portfolio includes: 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. The company’s commitment to innovation has earned significant 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.

RN Clinical Auditor - Behavioral Health

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

Job Summary:

We are 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 role evaluates quality of care, reviews medical records and program policies, identifies compliance issues, prepares audit documentation and reports, and supports appeals activities within behavioral health, psychiatric, and substance use disorder treatment settings.

Key Responsibilities:

• Review medical records and documentation to evaluate provider compliance with IHCP, CMS, AMA, and behavioral health-specific 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

Requirements

Required 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.
• 2+ year of Medicaid claims review, billing compliance, or healthcare reimbursement experience
• Comfortable completing a timed Excel proficiency assessment (sorting, filtering, VLOOKUP, conditional formatting), required by the client prior to submission.

Preferred Qualifications:

• CCS or CPC coding certification
• Knowledge of CPT and ICD-10 coding
• Experience with ASAM criteria, InterQual, or MCG guidelines for behavioral health level-of-care determinations