Dental Auditor
West Coast Dental Services · Los Angeles Metropolitan Area · 3 wk ago
AccountingFull-time
About the role
The Dental Auditor ensures clinical quality, regulatory compliance, and supports readiness for external reviews and accreditation surveys.
Responsibilities
- Perform clinical audits of dental records, and utilization to assess compliance with policies, CADP standards, state/federal regulations, and payer requirements.
- Evaluate medical necessity, coding accuracy (CDT), documentation quality, and adherence to evidence-based guidelines.
- Support readiness for external reviews and accreditation surveys; maintain audit tools, checklists, and SOPs.
- Provide provider education and feedback to improve documentation, coding, and clinical quality.
- Maintain strict confidentiality and data security in accordance with HIPAA and company policies.
Requirements
- Licensed Dentist in California with an active status
- CADP-certified auditor (preferred)
- If not currently certified, must obtain certification promptly upon hire
- Strong knowledge of dental benefit design, CDT coding, utilization management, and quality improvement principles
- Excellent analytical, documentation, and report-writing skills
- Strong communication skills with the ability to deliver clear feedback to providers and cross-functional partners
Qualifications
- Minimum 2 years of experience working with dental plans (payer, DSO, or managed care setting)
- Experience with CADP standards
- Familiarity with fraud/waste/abuse detection, root cause analysis, and corrective action planning
- Experience training or educating providers on documentation and coding best practices
Skills
- Strong analytical, documentation, and report-writing skills
- Strong communication skills
Benefits
N/A
Pay
$600 per day
Schedule
Full-time, Monday–Friday Primarily office-based, with potential travel for provider site audits within California.