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Behavioral Health Auditor Remote Jobs in Oregon (NOW HIRING)

EnableComp

DRG Auditor (REMOTE)

OR · Remote

$27.25 - $31/hr

EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations ... Position Summary The DRG Auditor is responsible for reviewing post-billed inpatient claims to ...

Imagine Pediatrics

Behavioral Health Care Manager

OR · On-site +1

$70K - $77K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

The primary location for this role is remote, and expected schedule requirements are Monday to ... What You'll Do As a Behavioral Health Care Manager (BHCM) with Imagine Pediatrics, you will work ...

Imagine Pediatrics

Coding Compliance Auditor

OR · Remote

$75K - $90K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... remote-first, high-growth environment. * Review medical records and clinical documentation to ... Serve as a subject matter expert on pediatric, Medicaid, telehealth, and behavioral health coding ...

RiteChoice Rx

Claims Auditor

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

This position is remote, with occasional travel to the corporate office. Essential Job Duties ... Health and vision insurance. * Dental insurance. * Paid time off. * 401(k) with employer matching.

HealthEdge

UM RN - Behavioral Health

Telephonic coordination and delivery of clinical behavioral health services designed to meet the ... Remote, US Type of Employment: Full-time, permanent FLSA Classification (USA Only): Exempt Work ...

Option Care

Nursing Quality Assurance Auditor - LPN

Salem, OR · Remote

$57/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... in healthcare. Summary: Reporting to the Director, Clinical Services Nursing, the Nursing Quality Assurance Auditor supports OCH's Clinical and Quality standards through on location and remote ...

New

Peregrine Health

Psychiatric Nurse Practitioner

OR · On-site +1

$127K - $130K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Peregrine Health - Redefining Behavioral Healthcare Psychiatric Mental Health Nurse Practitioner (PMHNP) $10,000 Signing Bonus for those licensed in Arkansas | 100% Remote | Full-Time W-2 | No Nights ...

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Behavioral Health Auditor Remote information

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

To thrive as a Behavioral Health Auditor (Remote), you need a strong background in behavioral health care, auditing principles, and regulatory compliance, typically supported by a relevant degree and auditing or clinical licensure. Familiarity with electronic medical records (EMRs), auditing software, and knowledge of standards such as HIPAA and NCQA are essential. Attention to detail, critical thinking, and effective written communication are vital soft skills for evaluating documentation and delivering clear feedback. These skills and qualifications ensure accurate audits, regulatory adherence, and continuous quality improvement in behavioral health organizations.

What is the difference between Behavioral Health Auditor Remote vs Behavioral Health Claims Reviewer?

AspectBehavioral Health Auditor RemoteBehavioral Health Claims Reviewer
Required CredentialsCertification in auditing or healthcare compliance, relevant licensesKnowledge of insurance policies, basic healthcare certifications
Work EnvironmentRemote, independent auditing tasks, data analysisRemote or onsite review of insurance claims, documentation
Employer & Industry UsageHealthcare organizations, insurance companies, government agenciesInsurance companies, third-party administrators, healthcare providers

Behavioral Health Auditor Remote and Behavioral Health Claims Reviewer roles both involve working with healthcare data remotely. Auditors focus on evaluating compliance and accuracy of behavioral health records, while claims reviewers primarily assess insurance claims for correctness. Both roles require knowledge of healthcare regulations and often share similar certifications, making them comparable in the behavioral health industry.

What are some common challenges faced by behavioral health auditors working remotely, and how can they be addressed?

Behavioral Health Auditors working remotely often encounter challenges such as staying up-to-date with frequently changing regulatory requirements, maintaining clear communication with providers and internal teams, and ensuring data security when handling sensitive patient information. To address these challenges, auditors can participate in regular training sessions, use secure communication platforms, and establish consistent check-ins with team members. Proactively seeking clarification on documentation and fostering a collaborative virtual environment can also help maintain audit accuracy and team cohesion.

What is a behavioral health auditor?

A Behavioral Health Auditor (Remote) is a professional who reviews and evaluates behavioral health records, billing, and compliance documentation from a remote location. Their primary responsibility is to ensure that healthcare providers follow state, federal, and organizational guidelines in delivering behavioral health services. They check for accuracy in clinical documentation, adherence to coding standards, and the proper use of billing codes. By identifying discrepancies or areas for improvement, they help organizations maintain compliance and improve the quality of care.

What are popular job titles related to Behavioral Health Auditor Remote jobs in Oregon?

For Behavioral Health Auditor Remote jobs in Oregon, the most frequently searched job titles are:

What job categories do people searching Behavioral Health Auditor Remote jobs in Oregon look for?

The top searched job categories for Behavioral Health Auditor Remote jobs in Oregon are:

What cities in Oregon are hiring for Behavioral Health Auditor Remote jobs?

Cities in Oregon with the most Behavioral Health Auditor Remote job openings:

Behavioral Health Auditor Remote jobs near you
Infographic showing various Behavioral Health Auditor Remote job openings in Oregon as of August 2026, with employment types broken down into 50% Full Time, and 50% Part Time. Highlights an 100% Remote job distribution.

DRG Auditor (REMOTE)

EnableComp

OR • Remote

$27.25 - $31/hr

Full-time

Posted 11 days ago

EnableComp rating

8.7

Company rating: 8.7 out of 10

Based on 8 frontline employees who took The Breakroom Quiz

46th of 491 rated business services

Job description

EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations, leveraging over 24 years of industry-leading expertise and its unified E360 RCM intelligent automation platform to improve financial sustainability for hospitals, health systems, and ambulatory surgery centers (ASCs) nationwide. Powered by proprietary algorithms, iterative intelligence from 10M+ processed claims, and expert human-in-the-loop integration, EnableComp provides solutions across the revenue lifecycle for Veterans Administration, Workers' Compensation, Motor Vehicle Accidents, and Out-of-State Medicaid claims as well as denials for all payer classes. By partnering with clients to supercharge the reimbursement process, EnableComp removes the burden of payment from patients and provider organizations while enabling accelerated cash, higher and more accurate yield, clean AR management, reduced denials, and data-rich performance management. EnableComp is a multi-year recipient the Top Workplaces award and was recognized as Black Book's #1 Specialty Revenue Cycle Management Solution provider in 2024 and is among the top one percent of companies to make the Inc. 5000 list of the fastest-growing private companies in the United States for the last eleven years. 
 
Position Summary
 
The DRG Auditor is responsible for reviewing post-billed inpatient claims to identify and validate missed reimbursement opportunities based on diagnosis and procedure coding. Working within a specialized DRG (Diagnosis-Related Group) database, DRG Reviewers utilize their technical expertise in ICD-10 coding to analyze medical records, determine coding accuracy, and make recommendations that optimize hospital reimbursement. This role requires certification as a Certified Coding Specialist (CCS) and a deep understanding of medical record documentation, clinical coding guidelines, and DRG reimbursement methodology. This position is responsible for handling patient health information (PHI) and maintaining extreme privacy and security as it relates to confidential and proprietary information.
Key Responsibilities
  • Review inpatient claims imported into the DRG database, focusing on diagnosis, procedures, grouping logic, and reimbursement accuracy.
  • Analyze weekly hospital billing files, identifying underpaid claims based on ICD-10 diagnosis and procedure codes.
  • Conduct detailed medical record reviews post-bill to determine if submitted diagnosis and procedure codes are accurate and complete.
  • Navigate medical records efficiently, targeting specific sections (e.g., discharge summary, operative reports) based on system edits and flagged items.
  • Match clinical documentation in the medical record to corresponding ICD-10 codes, ensuring DRG accuracy.
  • Identify and correct errors such as under coded or misclassified diagnoses and procedures.
  • Utilize Health ROI system edits to detect specific high-value opportunities (e.g., dialysis, occlusion, embolization, catheterization).
  • Make reimbursement improvement recommendations and submit findings for client review and approval.
  • Collaborate with leadership on case prioritization and workflow management.
  • Stay informed on coding updates, payer guidelines, and DRG changes to support accurate recommendations.
  • Analyze client reporting.
  • Identify new revenue opportunities related to all inpatient DRG related components.
  • Other duties as required.
Requirements and Qualifications
  • Associate's or bachelor's degree in health information management or related field required. (RHIT or RHIA credentialed individuals encouraged).
  • Certified Coding Specialist (CCS) certification required.
  • 2-3 years' experience in DRG validation, inpatient medical coding, or related coding review.
  • Strong understanding of ICD-10-CM/PCS coding guidelines, DRG reimbursement methodology, and hospital billing processes.
  • Proficient in reading and interpreting clinical documentation across multiple departments (e.g., nursing, operative, radiology, pharmacy).
  • Experience working in a post-bill coding environment and familiarity with DRG grouping software and billing databases.
  • Analytical thinker with a focus on financial impact and reimbursement accuracy.
  • Comfortable navigating multiple digital platforms, EMRs, and data systems.
  • Must have strong computer proficiency and understand how to use basic office applications, including MS Office (Word, Excel, and Outlook).
  • To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.  Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions.
Special Considerations and Prerequisites
  • This role is primarily office-based or remote, depending on company policy, with extensive computer and document review work.
  • Must be comfortable working independently in a detail-oriented, data-driven environment.
  • Excellent communication and documentation skills to support client reporting and recommendations.
  • High integrity and professionalism in handling PHI and confidential information.
  • Strong collaboration and responsiveness to feedback from leadership and client partners.
  • Ability to review and analyze large volumes of medical and billing data.
  • Strong focus and attention to detail in identifying discrepancies and ensuring compliance.
  • Ability to manage high volumes of case processing with accuracy and efficiency.
  • Ability to meet deadlines and handle time-sensitive workloads in a high-volume environment.
  • Proven written and verbal communication skills.
  • Strong analytical and problem-solving skills.
  • Ability to prioritize and manage multiple competing priorities and projects concurrently.
  • Proven experience working with external clients; strong customer service skills and business acumen.
  • Timely and regular attendance.
EnableComp is an Equal Opportunity Employer M/F/D/V. All applicants will be considered for this position based upon experience and knowledge, without regard to race, color, religion, national origin, sexual orientation, ancestry, marital, disabled or veteran status. We are committed to creating and maintaining a workforce environment that is free from any form of discrimination or harassment.
 
EnableComp recruits, develops and retains the industry's top talent.  As the employer of choice in the complex claims industry, EnableComp takes pride in our continuous commitment to building and maintaining a culture centered around fostering the professional growth and development of our people.  We believe that investing in our employees is the key to our success, and we are dedicated to providing them with the tools, resources, and support they need to thrive and grow their career here. At EnableComp, we are committed to living up to our core values each and every day, and we believe that this commitment is what sets us apart from other companies.  If you are looking for a company that values its employees and is dedicated to helping them achieve their full potential, then EnableComp is the place for you.
 
 Don't just take our word for it!  Hear what our people are saying:
"I love my job because everyone shares the same vision and is determined and dedicated. People care about you as a person and your professional growth. There is a genuine spirit of cooperation and shared goals all revolving around helping each other." - Revenue Specialist
 
"I enjoy working for EnableComp because of the Core Values we believe in. EnableComp stands true to these values from empowering employees to ecstatic clients. This company is family oriented and flexible, along with understanding the balance of work, life, and fun." - Supervisor, Operations
We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses and identifying potential inconsistencies or verification signals in application materials based on available information. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.
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