Dental Analyst I

Overview

Cotiviti is looking to add a Dental Analyst to our team. As a Dental Analyst you will perform daily audits on client data for completeness and accuracy of coding utilizing coding background to ensure appropriateness for reimbursement. The ideal candidate will have a background in dental coding/billing and have a comfort level on reviewing dental claims for completeness and alignment to coding & clinical guidelines. Having hands-on experience with dental procedures such as taking/reading x-rays, periodontal charting, assisting with dental procedures being performed is highly desired. This is a full-time position and can be done from home in the continental US.

Responsibilities

• Perform daily audits on client data for completeness and accuracy of coding utilizing coding background to ensure appropriateness for reimbursement. When providing recommendations on clinical claims to the client: Does not interpret or evaluate clinical information but performs duties according to structured algorithms or other written guidelines. Licensed personnel provide oversight and follow-up for clinical related questions or issues such as the use of the algorithms or structured guidelines.
• Respond to provider appeals of non-clinical issues.
• Respond to client logics and record reviews of non-clinical issues.
• Assess and respond to client/provider educational needs.
• Monitor acceptance rates for assigned clients and assist management in proactively detecting negative deviations. 
• Contribute to the team by providing feedback to the Management and Development team on changes to enhance the editing and efficiency as well as passing on client feedback. Participates on the Quality Committee as required. 
• Completes all responsibilities as outlined on annual Performance Plan.
• Must be able to perform duties with or without reasonable accommodation.

Qualifications

• High School Diploma, GED or equivalent work experience.
• Dental coding certificate preferred.
• Minimum of 3 years work experience in a dental office required (general dentist or oral surgeon).
• Has general knowledge of dental procedures, conditions, and treatment practices.
• Has excellent written and verbal communication skills.
• Has the ability to think logically and process sequentially with a high level of detailed accuracy.
• Has excellent personal computer skills in Microsoft Word, Excel, PowerPoint, Outlook, etc.
• Has the ability to conduct training to both internal staff and clients in an efficient and effective manner.

Job Demands: 

• This is a work at home position . Access to high speed internet is …