Remote Medicaid Pre-Billing Auditor – Compliance & Risk

Colonial Group; Littleton (CO); Remote; USD 75,000 - 95,000; Full time

Benefits offered by this job

Health and Wellness benefits

403(b) Retirement Savings Plan with 3.

Health Savings Account

Flexible Savings Account

Life, AD&D, STD, LTD insurance

Paid Time Off

Tuition Reimbursements

CPR certification training

Career Development training

Any Day Pay with Dayforce Wallet

Job summary

AbleLight seeks a Medicaid Pre-Billing Auditor to evaluate Medicaid billing, coding, authorizations, service documentation, and related reimbursement practices. This role emphasizes pre-billing audits, identifying billing risks, and limiting regulatory exposure for claims accuracy.

Remote position open to candidates in Colorado, California, Minnesota, Washington, Oregon or Missouri, with responsibilities in audits, reporting, cross-functional collaboration, and regulatory support.

Qualifications

• Bachelor’s degree in healthcare administration, accounting or related field; or an equivalent combination of education and experience.
• Minimum of five years of auditing experience, including reviewing claims, coding, and supporting documentation for accuracy and regulatory compliance.
• Professional credential: CPC, CCS-P, CPMA, CHC or another relevant healthcare credential.

Responsibilities

• Auditing and monitoring Medicaid claims and records to identify risks and ensure compliance.
• Determine documentation meets payer requirements; impose internal billing holds when needed.
• Evaluate coding and billing accuracy using CPT, HCPCS, ICD-10-CM and state-specific requirements.
• Prepare reports, dashboards and recommendations; support corrective actions and remediation.
• Collaborate with various departments and improve audit-management processes using analytics and AI tools.

Skills

Auditing experience

Claims review

Regulatory compliance

Education

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

Tools

Audit platforms

Data analytics tools

AI-assisted auditing

Job description

AbleLight seeks a Medicaid Pre-Billing Auditor to evaluate Medicaid billing, coding, authorizations, service documentation, and related reimbursement practices. This role emphasizes pre-billing audits, identifying billing risks, and limiting regulatory exposure for claims accuracy.

Remote position open to candidates in Colorado, California, Minnesota, Washington, Oregon or Missouri, with responsibilities in audits, reporting, cross-functional collaboration, and regulatory support.