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We’re looking for a Behavioral Health Auditor III to join us in a fully remote role. In this position, you’ll use your knowledge of payer policies, industry standards, and regulatory guidelines to review and audit Behavioral Health claims. Your work will directly impact the integrity of healthcare payments and help ensure accurate, compliant practices across the industry.
This isn’t just auditing—it’s about bringing insight, spotting trends, and helping shape the future of Behavioral Health payment integrity.
Responsibilities
What You’ll Do
- 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.
Qualifications
What We’re Looking For
- 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.
What You Bring
- 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.
- A passion for Behavioral Health auditing and a desire to thrive in a culture built on teamwork, collaboration, and excellence.
Why Join EXL?
At EXL, you’ll be part of a supportive, inclusive team that values expertise, collaboration, and growth. We believe in empowering our people to succeed while making a real impact on healthcare.
✨If you’re ready to bring your Behavioral Health expertise to a role that values accuracy, innovation, and teamwork, we’d love to hear from you!
