Clinical Chart Auditor

Clinical Chart Auditor

CMJ RECOVERY AZ LLC

Phoenix, AZ Job Details $60,000 a year 3 hours ago Qualifications Electronic health records (EHR) management Clinical documentation Clinical documentation improvement Productivity software Medical terminology Full Job Description We are seeking a detail-oriented and knowledgeable Clinical Chart Auditor to support the integrity, quality, and compliance of documentation within our Behavioral Health Program. This role is responsible for reviewing clinical records to ensure documentation meets internal standards, payer requirements, regulatory expectations, and applicable behavioral health guidelines. The ideal candidate has experience in behavioral health documentation, strong knowledge of medical necessity and compliance standards, and the ability to work collaboratively with clinical and leadership teams to improve documentation quality and reduce audit risk. The Clinical Chart Auditor will review behavioral health charts for completeness, accuracy, timeliness, and compliance with organizational, state, federal, and payer requirements. This includes evaluating assessments, treatment plans, progress notes, authorizations, discharge summaries, and other clinical documentation to confirm alignment with services provided and established standards of care. This role will identify documentation deficiencies, trends, and areas of risk, then communicate findings clearly to program leadership and clinical staff. The auditor will prepare audit reports, maintain audit tracking tools, and support corrective action planning when needed. The position may also assist with internal quality improvement initiatives, policy compliance reviews, readiness for external audits, and staff education related to best practices in clinical documentation. The Clinical Chart Auditor is expected to collaborate with therapists, case managers, psychiatrists, nurses, quality staff, and operations leaders to promote accurate documentation, improve chart compliance, and strengthen overall program performance. Required Qualifications Candidates should have a bachelor's degree in a relevant field such as social work, psychology, counseling, nursing, health information management, or healthcare administration. Equivalent combinations of education and relevant experience may also be considered. Applicants should have at least 2-3 years' experience in behavioral health, clinical documentation review, quality assurance, utilization review, compliance, or medical record auditing. Strong understanding of behavioral health terminology, levels of care, treatment planning, progress note standards, and documentation supporting medical necessity is required. The successful candidate must be highly organized, analytical, and comfortable reviewing large volumes of documentation with a high degree of accuracy. Strong written and verbal communication skills are essential, along with proficiency in electronic health records and Microsoft Office or similar reporting tools. Preferred Qualifications Preference may be given to candidates with experience auditing documentation in community mental health, substance use treatment, outpatient behavioral health, intensive outpatient, partial hospitalization, or other specialty behavioral health settings. Experience with Medicaid, Medicare, managed care documentation standards, Joint Commission, CARF, or state behavioral health regulations is strongly preferred. Clinical licensure or certification, such as

LPC, LCSW, LMFT, LMHC, RN

may be considered an asset depending on program needs. Essential Skills The ideal candidate demonstrates excellent critical thinking, attention to detail, sound judgment, and the ability to interpret documentation against clinical, regulatory, and payer expectations. They should be able to maintain confidentiality, manage competing deadlines, and present findings in a constructive, professional manner. A strong quality improvement mindset and the ability to build positive working relationships with clinical teams are especially important in this role. This position may be posted in multiple jurisdictions with varying pay transparency requirements. The compensation range provided is a good-faith estimate and may not reflect the full range applicable in all locations. Final compensation will be determined based on factors including, but not limited to, experience, skills, qualifications, geographic location, and applicable federal, state, and local laws. Required Qualifications Candidates should have a bachelor's degree in a relevant field such as social work, psychology, counseling, nursing, health information management, or healthcare administration. Equivalent combinations of education and relevant experience may also be considered. Applicants should have at least 2-3 years' experience in behavioral health, clinical documentation review, quality assurance, utilization review, compliance, or medical record auditing. Strong understanding of behavioral health terminology, levels of care, treatment planning, progress note standards, and documentation supporting medical necessity is required. The successful candidate must be highly organized, analytical, and comfortable reviewing large volumes of documentation with a high degree of accuracy. Strong written and verbal communication skills are essential, along with proficiency in electronic health records and Microsoft Office or similar reporting tools. Preferred Qualifications Preference may be given to candidates with experience auditing documentation in community mental health, substance use treatment, outpatient behavioral health, intensive outpatient, partial hospitalization, or other specialty behavioral health settings. Experience with Medicaid, Medicare, managed care documentation standards, Joint Commission, CARF, or state behavioral health regulations is strongly preferred. Clinical licensure or certification, such as

LPC, LCSW, LMFT, LMHC, RN

may be considered an asset depending on program needs.