Description
The Medicaid Pre-Billing Auditor independently evaluates Medicaid billing, coding, authorizations, service documentation, and reimbursement practices to determine claim accuracy and compliance. The role focuses on prospective and retrospective audits, billing holds, risk assessments, overpayment escalation, audit reporting, corrective-action monitoring, cross-functional collaboration, audit technology, and regulatory support. Candidates need a bachelor’s degree in healthcare administration, accounting, or a related field, at least five years of auditing or related experience, and a recognized healthcare coding, audit, compliance, or health-information credential. Benefits include medical, dental, vision, retirement matching, health savings and flexible savings accounts, paid time off, tuition reimbursement, and ongoing training.
