• Dental Claims Auditor

  • Overview

    MB2 

     

    We are a fast-paced, young and disruptive company working hard to make our doctor’s vision come to life. Unique individuals and ideas are always welcome here. Don’t settle for the norm. We are looking for the best of the best. Think you’re the right fit? We’d love to hear from you.

     

    Audit dental claims to ensure appropriate medical documentation and notes are present. The Dental Claims Auditor position is responsible for ensuring that the coded clinical and administrative data of our client offices are compliant with company policy, local, state, and federal laws, and assessing the overall coding quality in order to provide feedback to our clients.

    Responsibilities

    • Conduct clinical chart audits for MB2 Dental affiliated providers to determine compliance with Medicaid and other payers.
    • Read and analyze EOB’s and make proper adjustments according to MB2 claims processing criteria.
    • Send appeals to insurance carriers with justification as to why dental treatment should be paid.
    • Audit accounts to ensure proper fees have been posted.
    • Work with Compliance team to maximize office collections and minimize adjustments.
    • Communicate issues and suggestions to improve processes.
    • Ensure compliance with MB2 policies as well as State, Federal and other regulatory bodies.
    • Participate in meetings as required.
    • Other duties as assigned by management.

    Qualifications

    • Previous dental experience required
    • 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

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