Job Description
Description About the Company Familia Dental believes everyone deserves access to quality, compassionate dental care, and that starts with having the right providers in the right places. Established in 2008 we have grown over the years because of our quality dentistry and our caring approach to all people. Our practice exemplifies the core values of quality, honesty, and care in everything that we do.
Job Purpose The Quality Improvement Specialist will review treatment documentation to ensure compliance with care standards and recommend process improvements.
Responsibilities - Develop and manage comprehensive chart review projects, to evaluate clinical documentation, treatment effectiveness, and compliance.
- Review x-rays, patient charts and other patient records to ensure treatment/service provided is within guidelines of the standard of care guidelines.
- Review preauthorization paperwork to ensure the intended treatment meets the dental plan criteria and relevant program criteria.
- Proactively communicate with providers to request and obtain additional information or clarification as needed.
- Prepare reports for leadership committees highlighting key findings, trends and potential areas of improvement.
- Continuously update professional knowledge by leveraging available resources to stay current on dental plans, coverage options, and industry best practices.
- Recommend and assist in implementing corrective action plans and lead initiatives to enhance clinical quality, and documentation standards.
- May lead projects related to safety and compliance, providing strategic suggestions for process improvements.
- Other duties as may arise.
Requirements Qualifications/ Skill Sets - Ability to communicate effectively (verbal and written) persons of diverse backgrounds and educational levels.
- Excellent organization and interpersonal skills required.
- Excellent problem-solving skills to allow for the correct diagnosis of a problem along with potential solutions for resolution.
- Skilled in working with others in a team environment.
- Must be proficient in MS Office applications (Word, Excel, PowerPoint, and Access).
Education And Experience - Licensed Dental Hygienist preferred
- Minimum 5 years of experience in a clinical role or other similar related experience.
- Knowledge of dental procedures, terminology, and codes.
Physical Requirements - Ability to remain in a stationary position, sitting and/or standing, for extended time [e.g. sitting at a desk, working at a computer].
Benefits Offered - Health, Dental and Vision Insurance
- 401(k) Retirement Plan
- Paid Holidays & Time Off
- Access to Financial Advisors
- Basic Life & AD&D Insurance
- Voluntary Life Insurance
- Voluntary Short-Term & Long-Term Disability
- On demand Pay > Receive a portion of your check before payday!
Availability / Schedule - full time, Monday - Friday
- Remote work
Job Tags
Full time, Temporary work, Remote work, Monday to Friday,