Job Description
Quantitative Analysis - Performs comprehensive review of the record to assure the presence of all component parts, such as; correct name, health record number, signatures and dates where required, and all reports which appear to be indicated by the treatment rendered.
Qualitative Analysis - Evaluates the record for documentation, consistency, accuracy and correlation of recorded data, such as dental necessity and modifier usage. Ensures the final diagnosis as stated by the Dentist is valid, complete and accurately reflects the care and treatment rendered.
Medico-legal Requirements - Makes the final determination that the record is complete, accurate, and reflects data to justify the diagnosis and warrant treatment without infringing on decisions concerning a Dentist's clinical judgment.
Generates daily RPMS/EHR reports to review, identifies errors, inconsistencies, discrepancies and/or trends and discusses with the appropriate dental staff and recommends appropriate modifications to RPMS/EHR entry.
Assists with performing routine audits in accordance with the facility Compliance Plan and Performance Improvement, which may include findings from provider documentation trends, coding peer reviews, and reimbursement denials.