Overview Perform Dental daily review/audits on client data for completeness and accuracy of coding, utilizing coding background to ensure appropriateness for reimbursement when providing recommendations on clinical claims to the client: Makes certain the requirements for Current Dental Terminology (CDT), ADA and other related concessions are met. Performs duties according to structured algorithms or other written guidelines. Handles moderately complex issues, refers all medical necessity procedures to higher-level staff for approval or denial. Possesses solid working knowledge of subject matter. High school diploma or GED is required. Minimum of three years work experience in a clinical role in the dental office, as a Dental Assistant or Dental Hygienist. Ability to work as part of a team. Analytical thinking skills. Statistical knowledge. Technical expertise. Computer skills. Detail oriented. Ability to meet deadlines. Mathematical skills. Project management skills. Special projects and other duties as assigned by management. Reports to a department head or manager Responsibilities • Perform daily audits on client data for completeness and accuracy of coding utilizing coding background to ensure appropriateness for reimbursement. When providing recommendations on clinical claims to the client: Does not interpret or evaluate clinical information but performs duties according to structured algorithms or other written guidelines. Licensed personnel provide oversight and follow-up for clinical related questions or issues such as the use of the algorithms or structured guidelines. • Respond to provider appeals of non-clinical issues. • Respond to client logics and record reviews of non-clinical issues. • Assess and respond to client/provider educational needs. • Monitor acceptance rates for assigned clients and assist management in proactively detecting negative deviations. • Contribute to the team by providing feedback to the Management and Development team on changes to enhance the editing and efficiency as well as passing on client feedback. Participates on the Quality Committee as required. • Completes all responsibilities as outlined on annual Performance Plan. • Must be able to perform duties with or without reasonable accommodation. This job description is intended to describe the general nature and level of work being performed and is not to be construed as an exhaustive list of responsibilities, duties, and skills required. This job description does not constitute an employment agreement and is subject to change as the needs of Cotiviti and the requirements of the job change. Qualifications • High School Diploma, GED or equivalent work experience. • Dental coding certificate preferred - Have this credential or ability to sit for it. • Minimum of 3 years work experience in a clinical role in the dental office, as a Dental Assistant or Dental Hygienist. • Has general knowledge of dental procedures, conditions, and treatment practices. • Has excellent written and verbal communication skills. • Has the ability to think logically and process sequentially with a high level of detailed accuracy. • Has excellent personal computer skills in Microsoft Word, Excel, PowerPoint, Outlook, etc. • Has the ability to conduct training to both internal staff and clients in an efficient and effective manner. Mental Requirements: • Communicating with others to exchange information. • Assessing the accuracy, neatness, and thoroughness of the work assigned. Physical Requirements and Working Conditions: • Remaining in a stationary position, often standing or sitting for prolonged periods. • Repeating motions that may include the wrists, hands, and/or fingers. • Must be able to provide a dedicated, secure work area. • Must be able to provide high-speed internet access/connectivity and office setup and maintenance. • No adverse environmental conditions are expected. Base compensation ranges from $20.00 to $25.00 per hour. Specific offers are determined by various factors, such as experience, education, skills, certifications, and other business needs. Nonexempt employees are eligible to receive overtime pay for hours worked in excess of 40 hours in a given week, or as otherwise required by applicable state law. Cotiviti offers team members a competitive benefits package to address a wide range of personal and family needs, including medical, dental, vision, disability, and life insurance coverage, 401(k) savings plans, paid family leave, 9 paid holidays per year, and 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti. For information about our benefits package, please refer to our Careers page. Date of posting: 10/23/2026 Applications are assessed on a rolling basis. We anticipate that the application window will close on 12/23/2026, but the application window may change depending on the volume of applications received or close immediately if a qualified candidate is selected. #junior Originally posted on Himalayas