This position will Audit dental claims to ensure appropriate dental documentation and notes are present. The Dental Claims Auditor position is responsible for ensuring that the coded clinical and administrative data of our affiliated offices are compliant with company policy, local, state, and federal laws, and assessing the overall coding quality to provide feedback to our Dentists. Some travel required to our various Dental Clinics.
Perform real-time chart reviews in regards to compliance and Dental Resident’s documentation
· Reviews and audits dental records for accurate procedure and ADA description
· Oversees dental software to determine if coding, billing, claim follow-up, payments receipts, posting activities, and credit processing are being performed in an accurate and timely manner by the company.
· Educates providers/team members when deficiencies in documentation and code descriptions are identified.
· Tracks and reports on individual provider/team metrics with regard to certain common provider/team documentation errors.
· Ensure accounts are accurate in regard to proper consent forms, signed treatment plans, efficient chart notes, accurate billing, etc.
· Identifies and uses techniques to identify improvements in the efficiency and effectiveness of business processes at a basic level.
· Ensures every patient has completed paperwork, updated medical histories, etc.
· Other duties assigned by Manager
Must be a registered dental hygienist.
Excellent working knowledge of overall dentistry and dental hygiene procedures, dental patient screening and medical history documentation.
· Prior RDA experience preferred
· 3-5 years prior billing experience preferred
· 3-5 years experience with dental terminology preferred
· 3-5 years experience as an auditor preferred
· Must possess experience in the following areas:
· Local, State, and Federal compliance regulations
· Must possess strong communication and organization skills