Dental Fraud Investigator

Job Summary

A company is looking for a Dental Fraud & Abuse Investigator.

Key Responsibilities

• Conducts research and analysis of correspondence and fraud and abuse cases related to dental claims
• Communicates with members, providers, and attorneys regarding claims and policies
• Ensures compliance with state and federal mandated response time frames while managing a caseload

Required Qualifications, Training, and Education

• Bachelor's degree or equivalent work experience
• 2 years of experience in Claim Support or Customer Service preferred
• Knowledge of dental terminology and benefit plans
• Proficiency in computer applications such as Word and Excel
• Ability to work independently and handle multiple priorities under pressure