Claims Auditor 

A Claims Auditor is responsible for the accurate and timely processing of dental claims. 

Responsibilities

  • Verify that the patient information on the claim forms is accurate and matches the data in the system; including patient/member name, social security number, address, date of birth, etc.
  • Ensure that the proper treatment codes are assigned to the proper tooth number(s)
  • Verify the frequency of treatments to ensure proper benefit coverage
  • Responsible for properly encoding claims into the system
  • Ensure that most/all claims are encoded before each check run cycle’s cut off date
  • Ensure proficiency with dental terminology and Delta Dental processing policies
  • Verify information on claims edit reports
  • Track the total number of claims received
  • Generate periodic reports for quality control purposes
  • Process and maintain various reports associated with each check run process
  • Perform other duties as assigned by management to best meet the needs of the department

Experience and qualifications

  • Must have a high school diploma or equivalent education
  • Previous background or prior experience in claim processing is helpful
  • Ability to work well with other people

Compensation and benefits

Delta Dental provides an excellent compensation and benefits package including medical, dental, vision, life & disability insurance, paid vacation, sick leave, continuing education, and 401k. More information about benefits and company culture is available on our Careers page

How to apply

Applying for a job with Delta Dental of South Dakota is easy! Send us an email with your:

  • Cover letter;
  • Resume; and
  • Professional references.

Email your application