Licensed Coding Validation Specialist

To support accurate billing for behavioral health and substance use disorder services, the remote Licensed Coding Validation Specialist will review medical records and claims, ensuring compliance with coding standards and regulatory requirements. Key responsibilities Performs comprehensive analysis of claim information and medical records to validate accuracy of billed procedure and service codes Maintains expert knowledge of CPT and HCPCS Level II coding conventions specific to behavioral health and SUD services Analyzes and resolves coding issues related to reimbursement and compliance for behavioral health and SUD claims Required qualifications High School Diploma or equivalent GED Active, unrestricted nursing license (RN or LPN/LVN) or national coding certification (RHIA, RHIT, CPC, or CCS) Minimum of three years of experience in coding or auditing behavioral health and/or SUD claims Working knowledge of DSM-5 diagnostic coding and behavioral health/SUD documentation requirements Comprehensive knowledge of the APC structure and regulatory requirements for behavioral health and SUD services