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9h ago Curated

Clinical Provider Auditor II - Maryland Behavioral Health

Elevance Health

Job description

The Clinical Provider Auditor II is responsible for auditing behavioral health provider records to ensure compliance with regulatory and contractual requirements. This role involves reviewing clinical documentation, identifying overpayments or underpayments, and preparing audit reports. The position is remote but requires residence in Maryland and an active Maryland RN license. Requires 3+ years of clinical experience, preferably in behavioral health or auditing.

Key responsibilities

  • Conduct audits of behavioral health provider records
  • Review clinical documentation for compliance
  • Identify payment discrepancies and prepare reports
  • Collaborate with provider relations and legal teams

What you bring

  • Active Maryland RN license
  • 3+ years clinical experience
  • Knowledge of behavioral health regulations
  • Audit experience preferred

Tags

RemoteMaryland RNBehavioral HealthAudit

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