Compliance Auditor - CCBHC Services

About the role

As a Compliance Auditor for CCBHC Services at Horizon, you will conduct compliance audits of CCBHC services to ensure compliance with federal CCBHC criteria, state regulations, and payer requirements. You will evaluate documentation to identify non-billable services and compliance risks specific to CCBHC reimbursement methodologies. You will analyze audit findings to identify trends, gaps, and areas of noncompliance within the CCBHC service line. You will maintain and manage auditing tools and tracking systems specific to CCBHC audits. You will collaborate with CCBHC program leadership, clinical staff, and quality teams to communicate audit results and support corrective action planning. You will prepare and present audit findings and trends at QA Committee meetings and CCBHC leadership meetings. You will conduct targeted audits related to special initiatives, risk areas, or regulatory updates impacting CCBHC services. You will participate in ongoing compliance monitoring aligned with CCBHC program expectations. You will perform additional duties as assigned.

Responsibilities

• Conduct compliance audits of CCBHC services to ensure compliance with federal CCBHC criteria, state regulations, and payer requirements.
• Evaluate documentation to identify non-billable services and compliance risks specific to CCBHC reimbursement methodologies (e.g., PPS rate requirements).
• Analyze audit findings to identify trends, gaps, and areas of noncompliance within the CCBHC service line.
• Maintain and manage auditing tools and tracking systems specific to CCBHC audits.
• Collaborate with CCBHC program leadership, clinical staff, and quality teams to communicate audit results and support corrective action planning.
• Prepare and present audit findings and trends at QA Committee meetings and CCBHC leadership meetings.
• Conduct targeted audits related to special initiatives, risk areas, or regulatory updates impacting CCBHC services.
• Participate in ongoing compliance monitoring aligned with CCBHC program expectations.
• Perform additional duties as assigned.

Requirements

• Experience in behavioral health, quality assurance, compliance, or auditing required.
• 1 year of experience in medical records and understanding of regulations around documentation required.
• Bachelor’s degree in related field preferred.
• Experience working within a CCBHC program or familiarity with CCBHC criteria strongly preferred.

Qualifications

• Experience in behavioral health, quality assurance, compliance, or auditing required.
• 1 year of experience in medical records and understanding of regulations around documentation required.
• Bachelor’s degree in related field preferred.
• Experience working within a CCBHC program or familiarity with CCBHC criteria strongly preferred.

Skills

• Strong analytical skills.
• Excellent communication and interpersonal skills.
• Ability to work independently and as part of a team.
• Proficiency in Microsoft Office Suite.

Benefits

At Horizon, we offer a seamless onboarding experience that ensures your success in your new role. We also provide a comprehensive benefits package that includes:

• Company Culture: A supportive, team-based work environment.
• Diversity & Inclusion: Commitment to equity, racial justice, and equal opportunity.
• Trainings, Trainings, and More: An entire team dedicated to your personal development and professional growth.
• Team Building, Connection, and Relationships: Opportunities to connect with colleagues and build relationships.
• Retirement: 401(k) AND profit-sharing programs to ensure financial security.
• Student Loan Assistance: Help paying off student loans.
• Paid time off and paid holidays!
• Tuition assistance through a partnership with Capella University.

Pay

The range of pay for this position is $20.04 - $21.71. Starting pay may be impacted based on experience and education. Compensation adjustments are evaluated annually.

Schedule

This is a full-time position from Monday – Friday, 9:00am – 5:00pm.