Remote Medicaid Pre-Billing Auditor — Compliance & Risk

Colonial Group; Golden Valley (MN); Hybride; USD 65 000 - 90 000; Plein temps

Avantages offerts par ce poste

Health benefits

403(b) retirement plan with matching

Paid time off (PTO)

Tuition reimbursements

CPR certification training

Career development

Any Day Pay

Résumé du poste

AbleLight is seeking a Medicaid Pre-Billing Auditor to join our Compliance team. The role focuses on pre-billing audits, evaluating claims, coding, documentation, and reimbursement to reduce regulatory risk.

This remote position supports candidates in eligible states and emphasizes risk assessment, remediation, and collaboration with departments to improve billing practices. Strong auditing background and credentials are required, with opportunities for professional growth and impact on patient

Qualifications

• Bachelor's degree or equivalent experience required.
• Minimum five years auditing experience, including claims review and documentation.
• Professional credential required: CPC, CCS-P, CPMA, CHC, or other relevant credential.
• Remote work eligibility from CO, CA, MN, WA, OR or MO.

Responsabilités

• Audit Medicaid claims and records for risk-based, prospective, and retrospective reviews.
• Impose internal billing holds when pre-billing audits fail to meet standards.
• Evaluate coding and billing accuracy against CPT/HCPCS/ICD-10-CM and state requirements.
• Support payer audits, investigations, and regulatory inquiries.
• Elevate suspected overpayments and remediation follow-up.

Connaissances

Auditing

Regulatory compliance

Data analysis

Communication

Formation

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

Description du poste

AbleLight is seeking a Medicaid Pre-Billing Auditor to join our Compliance team. The role focuses on pre-billing audits, evaluating claims, coding, documentation, and reimbursement to reduce regulatory risk.

This remote position supports candidates in eligible states and emphasizes risk assessment, remediation, and collaboration with departments to improve billing practices. Strong auditing background and credentials are required, with opportunities for professional growth and impact on patient