[Hiring] Dental Auditor and Administrative Assistant @Group SSI

Role Description

Dental Coding Auditors duties will be to review patient charts, clinical notes, and dental claims to ensure accuracy in CDT (Current Dental Terminology), ICD-10-CM, and sometimes CPT/HCPCS codes, while safeguarding regulatory compliance and revenue integrity.

Key Responsibilities

• Chart & Claim Reviews: Audit dental records, x-rays, and treatment plans to verify that billed procedures are clinically supported and properly documented.
• Compliance & Regulations: Ensure adherence to guidelines from commercial dental plans, Medicaid, Medicare, and regulatory bodies.
• Error Identification and Root-Cause Analysis: Identify recurring billing errors-including unbundling, upcoding, and under-coding-and investigate providers or departments with high error rates.
• Provide a summary report of findings and recommendations.
• Provide training when needed.
• Review audit findings for trends and recommend corrective actions, with follow-up documentation as directed by consultants.
• Protect patient information during chart reviews and communicate audit findings only through authorized, secure channels.
• Ability to use secure electronic health record systems, VPN tools, and client portals; familiarity with IHS RPMS/EHR and Chargemaster systems is preferred.
• Ability to handle protected health information confidentially and follow applicable privacy and information security procedures.

Qualifications

• High school diploma or equivalent.
• Certified coder with at least 5 years of active Dental coding and/or auditing experience.
• Five years of experience in education and training of Healthcare providers regarding coding and documentation guidelines.

Requirements

• Working knowledge of health care compliance policies, practices and systems.
• Skilled in charge capture methodologies and challenges faced by providers in accurately capturing all appropriate charges.
• Strong written and verbal communication skills.
• Ability to manage work assignments with minimal supervision.
• Proficiency with Microsoft Word and PowerPoint and Microsoft Office products.
• Excellent analytical and organizational skills.
• Ability to manage multiple projects, meet deadlines, and work independently.
• Detail-oriented.
• Must be able to interpret procedure manuals, correspondence and instructions.
• Ability to prepare clear audit summaries, track coding discrepancies, and perform quality assurance checks.
• MMA may assign other related duties consistent with business needs.

Benefits

• Ability to work remotely.
• Mon-Fri workweek.

Physical Requirements

• Ability to sit or stand for extended periods of time. Occasional lifting.
• Ability to perform repetitive tasks/work functions in a controlled setting.
• Ability to perform the essential functions of the position with or without reasonable accommodation.

Work Environment

• Work remotely.
• Mon-Fri workweek.

Company Description

McManis & Monsalve Associates is an Equal Opportunity Employer. Employment decisions are made without regard to race, color, religion, sex (including pregnancy, sexual orientation and gender identity), national origin, age, disability, genetic information, protected veteran status, or any other status protected by applicable law. MMA provides reasonable accommodation as required by law.