Senior Dental Payment Integrity Analyst

Job Summary

A company is looking for a Senior Payment Integrity Dental Analyst.

Key Responsibilities

• Act as a subject-matter expert on dental payment integrity issues during discussions with carriers, TPAs, and clients
• Professionally present and defend payment integrity conclusions using claims data and clinical rationale
• Review dental claims and documentation to identify improper payments and produce clear documentation for review

Required Qualifications

• 5+ years of experience in dental payment integrity, dental claims analysis, or healthcare reimbursement
• Direct experience engaging with carriers and TPAs, including leading calls
• Strong understanding of dental billing workflows and CDT coding
• Ability to interpret and explain claims data without performing advanced analytics
• Bonus points for experience in dental fraud investigations and relevant professional certifications