Medical Record Audit Specialist
RADcube - A NLogix Company
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.
Core Service Portfolio
- 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.
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.
Certified Medical Coder/Medical Record Audit Specialist - Behavioral Health
Location: Fully Remote, with occasional travel to Downtown Indianapolis, IN (expenses covered)
Job Summary
We are seeking a Certified Medical Coder/Medical Record Audit Specialist with strong Behavioral Health coding experience to support a state Medicaid program engagement. This role focuses on auditing medical records and claims documentation for coding accuracy and compliance, identifying billing and documentation issues, and preparing audit work-papers and reports in alignment with CMS, AHIMA, and Indiana Medicaid standards.
Key Responsibilities
- Reviewmedicalrecords and related documentation to assess coding accuracy and compliance with Indiana Health Coverage Programs, CMS, AMA, and other applicable standards and regulations.
- Conduct coding and documentation reviews independently and provide preliminary findings to the Lead Reviewer.
- Identify potential coding discrepancies, documentation deficiencies, and billing compliance issues.
- Maintain detailed work-papers documenting procedures performed, records reviewed, findings identified, and conclusions reached.
- Assist with audit responses and appeals as needed.
- Ensure all work aligns with state, federal, and national coding and reimbursement guidelines.
- Stay current on CPT, HCPCS, ICD-10-CM, and Medicaid coding guidelines, policies, and regulatory updates.
- Research Indiana Medicaid rules and maintain internal repositories of bulletins, policies, and procedures.
- Adapt quickly to changing priorities, policies, regulatory updates, and review requirements while maintaining accuracy and meeting deadlines.
Requirements
Required Qualifications
- Active coding certification: CCS (AHIMA), CPC (AAPC), or CPMA (AAPC).
- Minimum 2-3 years of hands-on medical coding, claims review, or audit experience
- Significant experience coding Behavioral Health, Mental Health, or Psychiatric encounters
- Hands-on proficiency with ICD-10-CM, CPT, and HCPCS coding systems
- Experience conducting medical record audits, claims reviews, or supporting appeals
- Comfortable completing a timed Excel proficiency assessment (sorting, filtering, VLOOKUP, conditional formatting), required by the client prior to submission
Preferred Qualifications
- Familiarity with Indiana Medicaid (IHCP) policies and payer guidelines
- Knowledge of CMS regulations and AHIMA Standards of Ethical Coding
- Experience with Epic, Cerner, 3M Encoder, or similar EHR and encoder platforms
- Prior experience specifically supporting Medicaid audit or compliance functions.
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