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Behavioral Health Auditor Remote Jobs in Virginia

Sentara Healthcare

Compliance Coding Auditor

Norfolk, VA · On-site +1

Compliance Coding Auditor Performs a number of functions including those of physician education ... For positions that are available as remote work, Sentara Health employs associates in the following ...

Sentara Healthcare

Compliance Coding Auditor

Norfolk, VA · On-site +1

Compliance Coding Auditor Performs a number of functions including those of physician education ... For positions that are available as remote work, Sentara Health employs associates in the following ...

ODYSSEY BEHAVIORAL GROUP

Virtual IOP Therapist

Glen Allen, VA · Remote

$55K - $74K/yr

This remote position requires a LPC, LPCC, LCSW, LMFT, PsyD or equivalent in one of the following ... We are a part of Odyssey Behavioral Healthcare Network which offers a continuum of care within our ...

HopeLink Behavioral Health

Crisis Worker

Oakton, VA · Remote

$18 - $21/hr

For more than 60 years, PRS, now HopeLink Behavioral Health, has provided comprehensive and ... Remote PRIMARY DUTIES: * Respond to people reaching out for crisis support through our crisis ...

Beacon Talent

Remote Psychiatrist

Lexington, VA · Remote

$150 - $200/hr

Location: Remote (United States) Type: 1099 Independent Contractor, Part-Time or Full-Time ... Document within our behavioral health EMR to the standard required for payer review * Escalate ...

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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 Virginia?

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

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

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

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

Cities in Virginia 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 Virginia as of August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 15% Part Time, and 4% Contract. Highlights an 96% Physical, 1% Hybrid, and 3% Remote job distribution.

Inpatient Behavioral Health Utilization Management Clinician/LCSW/LPC/LMFT/RN - Remote in VA and NC

Sentara Healthcare

Norfolk, VA • On-site, Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 9 days ago

Sentara Health rating

6.7

Company rating: 6.7 out of 10

Based on 412 frontline employees who took The Breakroom Quiz

530th of 887 rated healthcare providers

Job description

City/State
Norfolk, VA
Work Shift
First (Days)
Overview:
Sentara Health Plans is hiring a Inpatient Behavioral Health Utilization Management Clinician/LCSW/LPC/LMFT/RN - Remote in VA and NC!
Status: Full-time, permanent position (40 hours)
Work hours: Flexible dayshift; Can start from 6am to 9am EST, M-F
Location: Fully remote in Virginia OR North Carolina.
Overview
  • Behavioral Health Utilization Management clinician is responsible for review of clinical information received from providers ensuring clinical data is substantial enough to meet Medical Necessity Criteria to authorize services as needed.
  • Requires knowledge of medical necessity criteria for behavioral health and substance use services, DMAS protocols, clinical protocols and clinical review requirements.
  • Requires knowledge of contractual, regulatory and compliance requirements for government payers, self-funded and commercial payers.
  • Ensures appropriate and accurate information is entered into claims system for processing of payment.

Education
  • Master's degree in Counseling, Social Work, or Marriage and Family Therapy REQUIRED
  • For Registered Nurses, a Bachelor of Science in nursing is REQUIRED

Certification/Licensure
REQUIRED license must be valid in state of practice. One of the following qualifies:
  • Licensed Clinical Social Worker (LCSW) - State license - Virginia Department of Health Professionals (VADHP) OR Licensed Clinical Social Worker (LCSW) - State license - North Carolina Social Work Certification and Licensure Board (NCSWCLB) OR
  • Licensed Professional Counselor (LPC) - State license - Virginia Department of Health Professionals (VADHP) OR Licensed Professional Counselor (LPC) - State license - North Carolina Board of Licensed Clinical Mental Health Counselors (NCBLCMHC) OR
  • Licensed Marriage and Family Therapist (LMFT) - State license - Virginia Department of Health Professionals (VADHP) OR Licensed Marriage and Family Therapist (LMFT) - State license - North Carolina Marriage and Family Therapy Licensure Board (NCBMFT) OR
  • Registered Nurse (RN) Single State - Nursing License - Virginia Department of Health Professionals (VADHP) OR Registered Nurse (RN) Single State - Nursing License - North Carolina Board of Nursing (NCBON) OR Registered Nurse (RN) Multi State - Nursing License - Virginia Department of Health Professionals (VADHP) OR Registered Nurse (RN) Multi State - Nursing License - North Carolina Board of Nursing (NCBON) OR
  • Licensed Substance Abuse Treatment Practitioner (LSATP)
  • Certified Substance Abuse Counselor (CSAC) OR Licensed Chemical Dependency Counselors (LCDC) preferred

Experience
  • 2 years of behavioral health REQUIRED
  • 1 year of case management REQUIRED
  • Inpatient Behavioral Health and health plan experience preferred

Sentara Health Plans provides health plan coverage to close to one million members in Virginia. We offer a full suite of commercial products including employee-owned and employer-sponsored plans, as well as Individual & Family Health Plans, Employee Assistance Programs and plans serving Medicare and Medicaid enrollees.
Our quality provider network features a robust provider network, including specialists, primary care physicians and hospitals.
We offer programs to support members with chronic illnesses, customized wellness programs, and integrated clinical and behavioral health services-all to help our members improve their health.
Our success is supported by a family-friendly culture that encourages community involvement and creates unlimited opportunities for development and growth.
Be a part of an excellent healthcare organization that cares about our People, Quality, Patient Safety, Service, and Integrity. Join a team that has a mission to improve health every day and a vision to be the healthcare choice of the communities that we serve!
To apply, please go to www.sentaracareers.com and use the following as your Keyword Search: JR-104143
Talroo - Health Plan
Managed Care, MCO, Health Plan, Healthcare, Masters, Social Work, Counseling Field, BSN, Nursing, Licensed Clinical Social Worker (LCSW), Licensed Professional Counselor (LPC), Licensed Marriage and Family Therapist (LMFT), Registered Nurse License (RN), Clinical, behavioral health, care coordination, discharge planning, continuity of care, transitions of care, Remote, Virginia, Days, North Carolina
Benefits: Caring For Your Family and Your Career
• Medical, Dental, Vision plans
• Adoption, Fertility and Surrogacy Reimbursement up to 10,000
• Paid Time Off and Sick Leave
• Paid Parental & Family Caregiver Leave
• Emergency Backup Care
• Long-Term, Short-Term Disability, and Critical Illness plans
• Life Insurance
• 401k/403B with Employer Match
• Tuition Assistance - 5,250/year and discounted educational opportunities through Guild Education
• Student Debt Pay Down - 10,000
• Reimbursement for certifications and free access to complete CEUs and professional development
• Pet Insurance
• Legal Resources Plan
• Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.
Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.
In support of our mission "to improve health every day," this is a tobacco-free environment.
For positions that are available as remote work, Sentara Health employs associates in the following states:
Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.

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