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EXL

Behavioral Health Auditor III

EXL

Behavioral Health Auditor III reviewing and auditing Behavioral Health claims. Joining EXL for a remote opportunity in healthcare payment integrity.

Posted 9/17/2025full-timeRemote • 🇺🇸 United StatesMid-LevelSenior💰 $70,000 - $80,000 per yearWebsite

About the role

Key responsibilities & impact
  • 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.

Requirements

What you’ll need
  • 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.

Benefits

Comp & perks
  • For more information on benefits and what we offer please visit us at https://www.exlservice.com/us-careers-and-benefits

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools
data analysisauditclaim adjustmentspayment integrityoverpayment auditing
Soft Skills
collaborationproblem-solvingcommunicationdocumentationtrend analysis
Certifications
CCSRHIARHITCPCRNMSW