Job Description
Position Summary:
Responsible for assisting Dental Director in development and administration of the Dental Fraud and Abuse program.
Responsible for educating dental offices, subscribers, and DDVA workforce on fraud and abuse prevention.
Assist in the creation and implementation of a Dental Fraud and Abuse manual.
Assist in conducting high level claims analysis to identify fraudulent and abusive patterns.
Makes recommendations for system/procedural changes within the corporation to deter dental fraud and abuse.
Responsible for conducting dental office audits.
Supports ongoing fraud investigations and requests for data.
Responsible for site audits throughout Virginia.
Coordinates with Dental Director and Compliance Officer regarding disposition of cases that may require prosecution of uncovered fraud.
This position will require some travel to dental offices throughout Virginia. Benefits:
8 paid holidays annually
6 sick days annually
10 days paid time off annually
Medical Insurance
Dental Insurance
401K
Requirements Essential Skills and Experience:
Position requires Bachelors degree or equivalent work experience in related field and excellent writing skills.
Preferred experience includes one or more of the following:
audit
data analysis
familiarity with fraud and abuse technology and predictive modeling
policy development and implementation and training
Please include a cover letter and resume.
Delta Dental of Virginia is an Equal Opportunity Employer Drug-Free Work Environment
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