About this role
Now is the time to join PDS Health. You will have opportunities to learn new skills from our team of experienced professionals. If you're ready to take your career to the next level and gain valuable experience, apply today!
The primary purpose and function of the Auditor, Insurance Claims is to adjudicate, re-bill and rebut insurance claims in order to ensure accurate and maximum reimbursement for patient treatment from insurance carriers.
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
Compensation Information
$22.00-$29.80 / Hourly
PDS Health is an Equal Opportunity Employer. We celebrate diversity and are united in our mission to create healthier and happier team members.
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Other facts
About PDS Health
Founded in 1994, PDS Health is a leading healthcare support organization that partners with dental and medical providers across the U.S., providing comprehensive business services that enable clinicians to focus on high-quality patient care.
Our innovative approach includes an integrated health record system that combines dental and medical data, giving clinicians a complete view of patient health. This platform enhances care coordination, allows for early detection of health issues, and improves patient outcomes, ultimately reducing overall healthcare costs.
We strive to be the provider of choice in every market by equipping clinicians with access to advanced, proven technologies and offering ongoing professional development opportunities. Our commitment to education and training supports clinicians and team members in growing their careers, ensuring they have the skills and knowledge to excel in their fields.
PDS Health has been recognized multiple times on the Inc. 5000 list of America’s fastest-growing private companies and named one of the 50 most community-minded companies in the nation. With over 1,000 practices in 24 states, we are dedicated to creating healthier, happier patients and making a positive impact in the communities we serve.
What you'll do
- The Auditor, Insurance Claims is responsible for adjudicating, re-billing, and rebutting insurance claims to ensure accurate reimbursement for patient treatment. This includes analyzing EOBs, sending appeals, auditing accounts, and ensuring compliance with company policies.
Ready to join PDS Health?
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