MMA- Dental Auditor and Administrative Assistant

Dental Auditor and Administrative Assistant Job Description -Full-time

Dental Auditor Job Description

Dental Coding Auditors duties will be to review patient charts, clinical notes, and dental claims to ensure accuracy in CDT (Current Dental Terminology), ICD-10-CM, and sometimes CPT/HCPCS codes, while safeguarding regulatory compliance and revenue integrity.

Key Responsibilities

· Chart & Claim Reviews: Audit dental records, x-rays, and treatment plans to verify that billed procedures are clinically supported and properly documented.

· Compliance & Regulations: Ensure adherence to guidelines from commercial dental plans, Medicaid, Medicare, and regulatory bodies.

· Error Identification and Root-Cause Analysis: Identify recurring billing errors-including unbundling, upcoding, and under-coding-and investigate providers or departments with high error rates.

· Provide a summary report of findings and recommendations.

· Provide training when needed.

· Review audit findings for trends and recommend corrective actions, with follow-up documentation as directed by consultants.

· Protect patient information during chart reviews and communicate audit findings only through authorized, secure channels.

· Ability to use secure electronic health record systems, VPN tools, and client portals; familiarity with IHS RPMS/EHR and Chargemaster systems is preferred.

· Ability to handle protected health information confidentially and follow applicable privacy and information security procedures.

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Administrative Assistant Job Description

Administrative Assistant with experience in handling a wide variety of client services related to healthcare coding and billing.

Work with McManis clients to gather report data, when needed, assist consultants with pulling medical records for audits, assist in maintaining the McManis Chargemaster Website, work with consultants and clients on Chargemaster updates, revisions, assist in setting clients up with secure access by using approved secure systems and VPN access to the McManis website and provide ongoing support services to McManis consultants and clients.

Once IHS RPMS and EHR access is complete:

Duties and Responsibilities include the following:

1. Charge master Webpage

a. Set up clients on Charge Master webpage

b. Educate clients on how to use the webpage and send password set up to clients on CM

c. Assist in annual coding updates

d. Upload revised coding worksheets for clients on CM webpage

Reports

1. Work with consultants to obtain raw report data, & various files via VPN for quarterly reports for clients

2. Work with McManis consultants and sub-contractors to provide necessary tools to conduct on-going audits

a. Pulls records and organizes audits for consultants and sub-contractor's

3. Run report data for consultants to analyze

4. Make revisions based on consultant input

Coding Worksheets Update Process

1. On an annual basis, contact clients for annual ticket updates (includes obtaining/confirming clients current coding worksheets for updating, order form and uploads coding worksheets to Charge master (CM) webpage for consultants, obtains clients coding worksheet requests/revisions annually

2. Perform status lookup, updating headers/footers

3. Complete QA, notifying if any error codes show up

4. Organize coding worksheet changes and uploads to CM webpage for consultants to review

5. Perform QA checks on all revised/completed coding worksheets

6. Create QA list of tran-codes on all coding worksheets for tracking purposes

7. Upload revised coding worksheets for clients via email and to CM webpage

Invoicing

1. Provide monthly invoices for client services provided

2. Maintain and update an excel spreadsheet of charges by client and payments received

3. Maintain and update and excel spreadsheet of estimated billable charges

4. Maintain accurate supporting documentation for invoices and escalate discrepancies for review.

5. Follow applicable HIPAA requirements, client agreements, and company policies.

Minimum Qualifications:

· High school diploma or equivalent.

· Certified coder with at least 5 years of active Dental coding and/or auditing experience.

· Five years of experience in education and training of Healthcare providers regarding coding and documentation guidelines.

Required Qualifications:

· Working knowledge of health care compliance policies, practices and systems.

· Skilled in charge capture methodologies and challenges faced by providers in accurately capturing all appropriate charges

· Strong written and verbal communication skills.

· Ability to manage work assignments with minimal supervision.

· Proficiency with Microsoft Word and PowerPoint and Microsoft Office products

· Excellent analytical and organizational skills.

· Ability to manage multiple projects, meet deadlines, and work independently.

· Detail-oriented

· Must be able to interpret procedure manuals, correspondence and instructions.

· Ability to prepare clear audit summaries, track coding discrepancies, and perform quality assurance checks.

· MMA may assign other related duties consistent with business needs.

Physical Requirements:

· Ability to sit or stand for extended periods of time. Occasional lifting.

· Ability to perform repetitive tasks/ work functions in controlled setting.

· Ability to perform the essential functions of the position with or without reasonable accommodation.

Work Environment:

· Work remotely

· Mon-Fri workweek

McManis & Monsalve Associates is an Equal Opportunity Employer. Employment decisions are made without regard to race, color, religion, sex (including pregnancy, sexual orientation and gender identity), national origin, age, disability, genetic information, protected veteran status, or any other status protected by applicable law. MMA provides reasonable accommodation as required by law.