Remote Medicaid Pre-Billing Auditor

AbleLight; Lyon Charter Township (MI); Remote; USD 95,000 - 105,000; Full time

Benefits offered by this job

Health, Dental and Vision benefits

403(b) Retirement Savings Plan with 3.

Dayforce Wallet and Any Day Pay

Job summary

AbleLight is seeking a Medicaid Pre-Billing Auditor to independently evaluate Medicaid billing, coding, authorizations, and service documentation to ensure accuracy and regulatory compliance. The role focuses on pre-billing audits and risk reduction, with limited reviews of commercial payer claims as needed.

The position is remote with preferred candidates in Colorado, California, Minnesota, Washington, Oregon or Missouri.

Qualifications

• Bachelor’s degree in healthcare administration, accounting or related field or equivalent experience.
• Minimum of five years of experience auditing or related function, reviewing claims, coding, and documentation.
• Certification in CPC, CCS-P, CPMA, CHC or other relevant credential preferred.

Responsibilities

• Auditing Medicaid claims and records; determine documentation meets payer requirements and impose internal holds.
• Analyze findings, prepare reports, and present to Compliance leadership.
• Collaborate with departments to evaluate and implement audit-management and analytics tools.
• Monitor remediation and ensure closure evidence and ongoing compliance.

Skills

Medicaid auditing

CPC credential

CCS-P credential

CPMA credential

CHC credential

Regulatory compliance

Auditing documentation

Education

Bachelor’s degree in healthcare administration, accounting or related field

Tools

Auditing software

Data analytics tools

Job description

AbleLight is seeking a Medicaid Pre-Billing Auditor to independently evaluate Medicaid billing, coding, authorizations, and service documentation to ensure accuracy and regulatory compliance. The role focuses on pre-billing audits and risk reduction, with limited reviews of commercial payer claims as needed.

The position is remote with preferred candidates in Colorado, California, Minnesota, Washington, Oregon or Missouri.