Dental Auditor

WEST COAST DENTAL ADMINISTRATIVE SERVICES LLC • Artesia, CA

16d • Hybrid

About The Position

The Dental Auditor ensures clinical quality and regulatory compliance within the Quality Management (QM) department. This role involves conducting clinical audits and reviews, identifying risks and trends, and collaborating with internal teams and providers to implement corrective actions and foster continuous improvement.

Requirements

• Licensed Dentist in California with an active status
• 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.

Nice To Haves

• CADP-certified auditor (preferred). If not currently certified, must obtain certification promptly upon hire.
• 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.

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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Ph.D. or professional degree