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Behavioral Health Clinical Auditor Jobs (NOW HIRING)

Molina Healthcare

Auditor, Healthcare Services

Waltham, MA · On-site

$30.37 - $59.21/hr

Audits for clinical gaps in care from a medical and/or behavioral health perspective to ensure ... Ensures auditing approaches follow a Molina standard in approach and tool use. Maintains member ...

MY House

Behavioral Health Clinical Manager

Wasilla, AK · On-site

$64K - $88K/yr

Behavioral Health Clinical Manager Location: Wasilla, AK Reports To: Behavioral Health Program Director Pay Range: 90-120,000 DOE Vision To End Homelessness. MISSION STATEMENT All youth experiencing ...

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How much do behavioral health clinical auditor jobs pay per year?

As of Sep 9, 2026, the average yearly pay for behavioral health clinical 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 is a behavioral health clinical auditor?

A Behavioral Health Clinical Auditor is a professional who reviews clinical documentation and records related to behavioral health services to ensure compliance with regulatory standards, payer requirements, and internal policies. They assess the accuracy, quality, and completeness of patient records, often looking for billing and coding accuracy, adherence to treatment protocols, and evidence-based practices. Their work helps organizations maintain high standards of care, avoid compliance issues, and improve overall service delivery. Behavioral Health Clinical Auditors often possess backgrounds in healthcare, behavioral health, or clinical documentation and may hold relevant certifications.

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

To thrive as a Behavioral Health Clinical Auditor, you need a strong understanding of behavioral health practices, clinical documentation standards, and regulatory compliance, typically supported by a degree in nursing, social work, or a related field and relevant licensure. Familiarity with auditing software, electronic health records (EHRs), and knowledge of CMS or Joint Commission guidelines is often required. Attention to detail, analytical thinking, and effective communication are critical soft skills for accurately reviewing records and collaborating with multidisciplinary teams. These competencies ensure audits are thorough, compliant, and contribute to the delivery of high-quality behavioral health services.

What are some common challenges faced by behavioral health clinical auditors during the audit process?

Behavioral Health Clinical Auditors often encounter challenges such as navigating complex and evolving regulatory requirements, managing large volumes of clinical documentation, and addressing discrepancies in records. They must maintain objectivity while ensuring compliance with industry standards and payer guidelines. Additionally, collaborating effectively with clinicians and administrative staff to clarify findings or gather additional information is key, as is balancing thoroughness with efficiency to meet audit deadlines.
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Behavioral Health Clinical Auditor jobs near you
Infographic showing various Behavioral Health Clinical Auditor job openings in the United States as of September 2026, with employment types broken down into 100% Part Time. Highlights an 100% In-person job distribution, with an average salary of $76,256 per year, or $36.7 per hour.

RN Clinical Auditor - Behavioral Health

Indianapolis, IN • On-site

RADcube
Custom Software Development Services • 201 - 500 employees
Learn more about RADcubeexternal

Other

Posted 8 days ago

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/behavioral health claims

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 HealthLocation: 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
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
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