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Auditor, Insurance Claims

Auditor, Insurance Claims

Pacific Dental ServicesIrving, Texas, US
30+ days ago
Job description

Responsibilities

  • Read and analyze EOB’s and make proper adjustments according to PDS claims processing criteria
  • Sends appeals to insurance carriers with justification as to why dental treatment should be paid.
  • Audit accounts to ensure proper fees have been posted.
  • Works with CBO team to maximize office collections and minimize adjustments.
  • Communicate issues and suggestions to improve processes.
  • Ensure compliance with Company policies as well as State, Federal and other regulatory bodies.
  • Participate in meetings as required.
  • Maintain an appropriate professional appearance and demeanor in accordance with Company policy.
  • Other duties as assigned by management.

Required

  • Equivalent to high school diploma or general education degree (GED).
  • 2-4 Years of related experience in the dental field.

    • Preferred

  • EPIC knowledge.
  • Bachelor’s Degree and 3 to 5 years of related experience.
  • Prior experience as a claims auditor within a group practice environment.

    • Knowledge / Skills / Abilities

  • Ability to multi-task effectively without compromising the quality of the work.
  • Excellent interpersonal, oral and written communication skills.
  • Detail oriented, organized, process focused, problem solver, proactive, ambitious, customer service focused.
  • Ability to draw conclusions and make independent decisions with limited information.
  • Ability to respond to common inquiries from customers, staff, regulatory agencies, vendors, and other members of the business community.
  • Self-motivated, reliable individual capable of working independently as well as part of a team.
  • Problem solving skills to gather & analyze information in order to identify and resolve problems ina timely manner arrive at valid conclusions, recommendations, and plans of action.
  • Analytical skills to synthesize complex or diverse information. Ability to research information andanalyze data to arrive at valid conclusions, recommendations, and plans of action.
  • Actively share ideas in a constructive and positive manner by listening to and objectivelyconsidering ideas and suggestions from others.

    • Benefits

  • Medical, dental, and vision insurance
  • Paid time off
  • Tuition Reimbursement
  • 401K
  • Paid time to volunteer in your local community