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Dental Auditor

Delta Dental of Michigan Logo

62867 - 80066 USD

Delta Dental of Michigan

Oak Brook, IL

Steven R. Olson

$5 to $25 million (USD)

Nonprofit Organization

Insurance

Published 3 days ago

This is a remote position.

Delta Dental of Michigan may be required to comply with applicable federal, state, and local COVID-19 workplace safety laws, regulations, and/or orders. Delta Dental of Michigan reserves the right to require all employees, as a term and condition of employment, to comply with such requirements or obtain an approved medical or religious accommodation in accordance with applicable law.

Delta Dental of Michigan, Ohio, and Indiana is a leader in dental benefits, plus so much more.

We improve oral health through benefit plans, advocacy and community support, and our corporate giving builds healthy, smart, vibrant communities for all. We devote our time, talents and financial resources to improve oral and overall health, and we invest in initiatives that support youth, education, workforce and economic development.

We are a force for good-part of the reason why employees find working at Delta Dental fulfilling. Delta Dental companies nationwide comprise the Delta Dental Plans Association, which provides coverage to more than 83 million Americans and operates two of the nation's largest networks of participating dentists. For more, visitwww.deltadentalmi.comandwww.vibrantcommunities.com, and apply online atwww.deltadentalmi.com/careers.

Typical Assignments:

  • Analyzes, adjudicates, and processes dental claims so that clinical determinations can be finalized using policies, procedures, and bypasses.
  • Reads, interprets, and compares radiographs and/or dental history with treatment plan
  • Reviews member's group coverage to determine type and level of benefits
  • Pre and post-screens claims for dental consultants
  • Uses system and other sources to obtain information needed to process claim determinations, including DeltaUSA processing policies, group contracts, provider agreements, and federal and state laws applicable to claims adjudication
  • Determines payment amounts when appropriate
  • Reviews, modifies and corrects claims in the system as needed, including claims that are not billable to the patient
  • Sends requests to dental offices seeking additional claim information, using proper grammar and punctuation
  • Calculates basic mathematical functions
  • Operates office equipment, which may include a personal computer, calculator, copier, fax machine, etc.
  • Maintains claims records and related departmental records and files

#LI-Remote

Requirements:

Bidding Requirements:

  • Possess a high school diploma or equivalent
  • Delta Dental approved dental assisting certificate OR one-year dental office chairside assisting
  • Successful completion of Professional Services Dental Assessment (minimum of 85% accuracy)


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