Clinical Auditor

SpringHealth Behavioral Health and Integrated Care•Lawrenceville, GA

1d•$15 - $17

About The Position

Clinical Auditor (Adult Waiver Compliance) – Full Time Our SpringHealth Behavioral Health team is growing, and we are looking for a Full-time detail-driven Clinical Auditor who is passionate about quality, compliance, and ensuring exceptional care for the individuals we serve. In this role, you will play a key part in protecting the integrity of our services by conducting audits of clinical records, documentation, and billing alignment to ensure compliance with Georgia Adult Waiver requirements, Medicaid standards, and company policies. Clinical auditors help healthcare organizations maintain regulatory compliance and improve quality of care by reviewing documentation and identifying opportunities for improvement. If you enjoy working with data, clinical documentation, and Excel, and take pride in ensuring services meet the highest standards, this is an opportunity to make a meaningful impact behind the scenes of care delivery. At SpringHealth, our mission is simple: help people live their best life. By ensuring regulatory and clinical excellence, you help safeguard the quality of services provided to individuals receiving support through Georgia’s Medicaid waiver programs.

Requirements

High school diploma or equivalent required
Strong organizational and time-management skills with the ability to prioritize tasks effectively
Exceptional attention to detail and accuracy
Ability to follow established processes, guidelines, and documentation standards
Strong communication skills and ability to work collaboratively within a team
Ability to manage multiple responsibilities in a fast-paced environment while maintaining quality and compliance

Nice To Haves

Experience working as an auditor a preferred but not required

Responsibilities

Conduct internal audits of clinical documentation, service notes, and billing records
Ensure alignment with Georgia Adult Waiver requirements and Medicaid regulations
Identify documentation gaps and compliance risks and provide recommendations for correction
Analyze audit findings and prepare reports to support operational and clinical leadership
Collaborate with clinical and operational teams to strengthen documentation practices and compliance processes
Utilize Excel and data analysis to track trends, audit results, and compliance metrics
Use excel and other company forms to maintain audit
Conduct routine and random audits of clinical records for Adult Waiver participants.
Review documentation for compliance with Georgia Medicaid waiver standards, DBHDD requirements, and internal policies.
Staff credentialing documentation related to service provision
Ensure services rendered align with authorized units and documentation supports billing claims.
Identify missing documentation, expired documents, and compliance gaps.
Maintain organized electronic and/or physical files in compliance with record retention standards.
Support data entry and reporting for leadership.
Assist with document preparation for audits and regulatory submissions.
Coordinate documentation requests from clinicians and supervisors.
Support internal workflow processes and other administrative tasks as assigned.
Develop audit reports with clear findings and corrective recommendations.
Track recurring compliance issues and recommend system-level improvements.