Dental Fraud & Abuse Investigator

Delta Dental of Virginia; Roanoke (VA); On-site; USD 60,000 - 80,000; Full time

Benefits offered by this job

Annual Incentive Plan

Comprehensive insurance coverage

Tuition reimbursement

Generous Holiday/PTO offerings

Health and Wellness programs

Job summary

A dental insurance provider in Virginia is seeking a Dental Fraud & Abuse Specialist to join their team. Responsibilities include investigating claims data and patient records to detect fraud, along with collaborating with various internal departments. Candidates must hold a degree in dental hygiene, possess an x-ray license, and have at least 8 years of clinical experience in dental settings. Excellent analytical and communication skills are essential for this role, which also involves travel throughout Virginia for audits.

Qualifications

• Must be a dental hygienist with at least 8 years of clinical experience.
• Experience with business aspects of a dental office is preferred.
• Ability to review records and interpret radiographs to detect fraud.

Responsibilities

• Detect and deter fraud by investigating claims data.
• Research patient records to identify potential fraud.
• Interact with multiple departments to analyze dental practices.

Skills

Analytical skills

Strong interpersonal skills

Excellent written communication

Verbal communication skills

Ability to think strategically

Education

Degree in dental hygiene

X-ray license

Job description

A dental insurance provider in Virginia is seeking a Dental Fraud & Abuse Specialist to join their team. Responsibilities include investigating claims data and patient records to detect fraud, along with collaborating with various internal departments. Candidates must hold a degree in dental hygiene, possess an x-ray license, and have at least 8 years of clinical experience in dental settings. Excellent analytical and communication skills are essential for this role, which also involves travel throughout Virginia for audits.