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Behavioral Health Auditor Jobs (NOW HIRING)

City of Mesquite

Behavioral Health Manager

Mesquite, TX

$83K - $99K/yr

Serves as the City's subject matter expert on behavioral health, crisis response, homelessness, and ... auditing, and performance requirements. Identify and pursue alternative funding opportunities ...

City of Mesquite, TX

Behavioral Health Manager

Mesquite, TX · On-site

$83K - $99K/yr

Serves as the City's subject matter expert on behavioral health, crisis response, homelessness, and ... auditing, and performance requirements. * Identify and pursue alternative funding opportunities ...

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Behavioral Health Auditor information

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$76.3K

$121.5K

How much do behavioral health auditor jobs pay per year?

As of Aug 7, 2026, the average yearly pay for behavioral health auditor in the United States is $76,256.00, according to ZipRecruiter salary data. Most workers in this role earn between $53,500.00 and $98,500.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a behavioral health auditor?

To thrive as a Behavioral Health Auditor, you need a strong background in clinical compliance, behavioral health standards, and audit processes, often supported by a degree in healthcare or related fields and experience in behavioral health settings. Familiarity with auditing software, electronic health records (EHR) systems, and certifications such as Certified Professional Medical Auditor (CPMA) are highly valuable. Strong analytical skills, attention to detail, effective communication, and the ability to navigate sensitive situations with professionalism are crucial soft skills. These competencies ensure accurate assessments, regulatory compliance, and constructive feedback that supports quality improvement in behavioral health organizations.

What does a behavioral health auditor do?

A typical day for a Behavioral Health Auditor involves reviewing patient records for compliance with federal, state, and organizational standards, conducting on-site or remote audits, and preparing detailed reports on findings. Auditors often collaborate closely with clinical staff, compliance officers, and management to clarify documentation standards and recommend process improvements. The role may also include participating in policy reviews, providing training or feedback, and staying updated on evolving regulations in behavioral health care. This dynamic environment requires balancing independent analysis with teamwork and periodic travel for on-site reviews.

What is a behavioral health auditor?

A Behavioral Health Auditor is responsible for reviewing and assessing clinical documentation, billing practices, and compliance with regulatory standards in behavioral health services. They ensure that providers adhere to federal, state, and insurance guidelines while maintaining high-quality patient care. This role involves conducting audits, identifying discrepancies, and recommending corrective actions to improve compliance and efficiency. Auditors may also provide training to staff on best practices and regulatory requirements.

More about Behavioral Health Auditor jobs
What cities are hiring for Behavioral Health Auditor jobs? Cities with the most Behavioral Health Auditor job openings:
What are the most commonly searched types of Behavioral Health Auditor jobs? The most popular types of Behavioral Health Auditor jobs are:
What states have the most Behavioral Health Auditor jobs? States with the most job openings for Behavioral Health Auditor jobs include:
What job categories do people searching Behavioral Health Auditor jobs look for? The top searched job categories for Behavioral Health Auditor jobs are:
Behavioral Health Auditor jobs near you
Infographic showing various Behavioral Health Auditor job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 77% Full Time, 17% Part Time, and 5% Contract. Highlights an 96% Physical, 1% Hybrid, and 3% Remote job distribution, with an average salary of $76,256 per year, or $36.7 per hour.

Medical Review Nurse - Home Health Auditor

Machinify

Remote

Full-time

Posted 15 days ago

Job description

Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plan clients across the country. Deployed by over 85 health plans, including many of the top 20, and representing more than 270 million lives, Machinify brings together a fully configurable and content-rich, AI-powered platform along with best-in-class expertise. We're constantly reimagining what's possible in our industry, creating disruptively simple, powerfully clear ways to maximize financial outcomes and drive down healthcare costs.
The Medical Review Nurse II primarily performs medical claims audit reviews with a focus on the Home Health sector. As a MR Nurse Auditor, you will join a team of experienced medical auditors and coders performing retrospective and prepayment audits on claims for Government and Commercial Payers. You will work remotely in a fast-paced and dynamic environment and be part of a multi-location team.
Key Responsibilities:
  • Auditing claims for medically appropriate services provided for inpatient settings while applying appropriate medical review guidelines, policies and rules.
  • Document all findings referencing the appropriate policies and rules.
  • Generate letters articulating audit findings.
  • Support your findings during the appeals process if requested.
  • Working collaboratively with the audit team to identify and obtain approval for particular vulnerabilities and/or cases subject to potential abuse.
  • Keep abreast of medical practice, changes in technology, and regulatory issues that may affect our clients.
  • Work with the team to minimize the number of appeals; Suggest ideas that may improve audit workflows; Assist with QA functions and training team members.
  • Cross train in all clinical departments/areas.
  • Other duties as required to meet business needs.

Knowledge, Skills and Abilities Needed:
  • Experience with utilization management systems or clinical decision-making tools such as Medical Coverage Guidelines (MCG) or InterQual.
  • Experience with and deep knowledge of ICD-9, ICD-10, CPT-4 or HCPCS coding.
  • Knowledge of insurance programs program, particularly the coverage and payment rules.
  • Ability to maintain high quality work while meeting strict deadlines.
  • Excellent written and verbal communication skills.
  • Ability to manage multiple tasks including desk audits and claims review.
  • Must be able to independently use standard office computer technology (e.g. email SharePoint, slack, outlook calendar etc.)
  • Must be able to manage multiple assignments effectively, create documentation outlining findings and/or documenting suggestions, organize and prioritize workload
  • Effectively work independently and as a team, in a remote setting.

Education Requirements:
  • An associate or bachelor's degree in nursing (active/unrestricted RN license) is required.
  • Medical Coding certification is preferred (see below for examples).
    • CCDS - Certified Clinical Documentation Specialist
    • CDIP - Clinical Documentation Improvement Practitioner
    • CCS - Certified Coding Specialist
    • CIC - Certified Inpatient Coder

Required and Preferred Qualifications:
  • Home Health claims auditing, quality assurance and/or recovery auditing experience of 2 years or more required. Experience of 3 or more years is preferred.
  • Must have Home Health experience.
  • Strong focus on quality and attention to detail.
  • Deep curiosity and analytical skills to understand root causes of events and behaviors.
  • Proven ability to apply critical judgment in clinical determinations; medical coding ability preferred.
  • In-depth knowledge of clinical criteria and documentation requirements to support code assignments.
  • Understanding of ICD-10-CM/PCS coding, UHDDS definitions, Official Coding Guidelines, and AHA's Coding Clinic Guidelines is preferred.
  • Ability to work independently and efficiently in a remote environment.

Equal Employment Opportunity at Machinify
We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender, gender identity or expression, or veteran status. We are proud to be an equal opportunity workplace. Machinify is an employment at will employer. We participate in E-Verify as required by applicable law. In accordance with applicable state laws, we do not inquire about salary history during the recruitment process. If you require a reasonable accommodation to complete any part of the application or recruitment process, please let our recruiters know. See our Candidate Privacy Notice at: https://www.machinify.com/candidate-privacy-notice/

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