Medicaid Pre-Billing Auditor

The Medicaid Pre-Billing Auditor independently evaluates Medicaid billing, coding, authorizations, and service documentation to ensure claims are accurate and compliant with federal and state requirements. This role focuses on pre-billing audits to identify risks, impose billing holds, and recommend corrective actions to reduce regulatory exposure. The position also involves conducting risk-based audits, maintaining defensible audit reports, and collaborating with cross-functional teams to implement compliance monitoring tools.