Dental Analyst I

Responsibilities

• Perform Dental daily review/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: Makes certain the requirements for Current Dental Terminology (CDT), ADA and other related concessions are met. Performs duties according to structured algorithms or other written guidelines. Handles moderately complex issues, refers all medical necessity procedures to higher-level staff for approval or denial. Possesses solid working knowledge of subject matter
• 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
• Special projects and other duties as assigned by management

Preferred

• Dental coding certificate preferred - Have this credential or ability to sit for it

Benefits

• Medical, dental, vision, disability, and life insurance coverage
• 401(k) savings plan
• Paid family leave
• 9 paid holidays per year
• 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti
• Glassdoor
• 3.4
• Healthcare data analytics and workflow solutions for payers and providers.
• Atlanta, Georgia, USA
• http://www.cotiviti.com
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Qualifications

• High school diploma or GED is required
• Minimum of three years work experience in a clinical role in the dental office, as a Dental Assistant or Dental Hygienist
• Ability to work as part of a team
• Analytical thinking skills
• Statistical knowledge
• Technical expertise
• Computer skills
• Detail oriented
• Ability to meet deadlines
• Mathematical skills
• Project management skills
• High School Diploma, GED or equivalent work experience
• Minimum of 3 years work experience in a clinical role in the dental office, as a Dental Assistant or Dental Hygienist
• 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
• Dental coding certificate preferred - Have this credential or ability to sit for it
• Minimum of three years work experience in a clinical role in the dental office, as a Dental Assistant or Dental Hygienist.
• Minimum of 3 years work experience in a clinical role in the dental office, as a Dental Assistant or Dental Hygienist.

Required skills

• Current Dental Terminology (CDT), Dental Coding, Dental Procedures and Treatment Practices, Microsoft Excel, Microsoft Outlook, Microsoft PowerPoint, Microsoft Word

Experience

• 3+ years