Behavioral Health Auditor III

🕒 4 days ago

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EXL

WebsiteLinkedInAll Job Openings

10,000+ employees

💰 $2M Venture Round on 2015-01

Choosing a digital partner is about more than capabilities — it’s about collaboration and character.

📋 Description

• Audit and review Behavioral Health claims to identify potential errors. • Analyze data against payer policies, procedures, and regulatory requirements. • Document findings clearly and professionally to support next steps. • Recommend claim adjustments or recoveries when necessary. • Collaborate with cross-functional teams to solve problems and drive improvements. • Stay ahead of the curve on regulations, laws, and industry standards. • Track and report audit findings, spotting trends and opportunities. • Share your expert knowledge to guide teams on Behavioral Health payment integrity issues. • Meet EXL’s productivity and quality goals while maintaining compliance with HIPAA and other regulations.

🎯 Requirements

• Education: Bachelor’s degree in healthcare administration, business, finance, or a related field. • Experience: 3+ years in Behavioral Health services (mental health and substance use disorder treatment). • Credentials (Preferred): CCS, RHIA, RHIT, CPC, RN, MSW – bonus points if you have multiple! • Expertise: Strong understanding of Behavioral Health standards, payer policies, and regulations. • Bonus: Experience in Behavioral Health retrospective overpayment auditing. • Ability to work independently in a fully remote environment. • Strong time management and prioritization skills. • A problem-solving mindset and ownership of results. • Excellent communication skills (both written and verbal). • Sharp analytical skills and great attention to detail. • Proficiency in Microsoft Excel, Word, and OneNote.

🏖️ Benefits

• Up to 10% annual travel (for team meetings and limited client onsite engagements.) • Professional development opportunities