Dental Billing & Clinical Audit Coordinator
The primary responsibilities of this role include reviewing completed patient charts and clinical notes to compare documented procedures with billed CDT codes, verifying that all completed procedures were properly billed, identifying missed billable procedures or coding discrepancies, and ensuring documentation appropriately supports all procedures billed. This includes identifying issues such as x-rays taken but not billed, fluoride or nitrous charges not entered, missing tooth numbers or surfaces, incomplete narratives, behavior guidance documentation gaps, and incomplete sedation documentation. The role will also involve x-ray and imaging reconciliation, including verifying that radiographs taken match what was billed and submitted, ensuring images are attached correctly to insurance claims, and identifying missing or incorrect x-ray submissions. In addition, the position will oversee accounts receivable processes by monitoring insurance aging reports, reviewing denied or delayed claims, ensuring claims are followed up appropriately, identifying trends causing delays or denials, and verifying claims are submitted in a timely manner. A weekly revenue integrity report will also be required summarizing completed encounters reviewed, missing charges, incomplete notes, unsubmitted claims, AR aging concerns, denied claims requiring follow-up, coding or documentation discrepancies, and recommendations for operational improvement. Must be willing to learn oryx software system.