Dental Analyst III (Part-time)

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.

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 medically necessary clinical information but performs duties according to structured algorithms or other written guidelines. Only licensed personnel provide oversight and follow-up for clinical related questions or issues such as the use of the algorithms or structured guidelines.
• State Licensure (renew license, submit new applications, respond to attestations, other special requests).
• URAC (renew accreditation when due, responds to all special requests).
• Train Dental New Hires.
• Audit New Hires 100%
• Train/Assist training clients on Nucleus.
• Train on Client Imaging systems.
• Monthly Quality Audit of Analyst.
• May provide leadership, coaching, and/or mentoring to a subordinate group. May act as a lead or first-level supervisor.
• Coding Dental Certification (CDC) is required.
• 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, which include providing explanation of coding rationale with little assistance.
• Monitor acceptance rates for assigned clients and assist management in proactively detecting negative deviations.
• Contribute to DCA 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.
• Mentor other analysts in learning the rules, guidelines of coding, and the application of company policies and procedures for claim review, appeals, pre-authorizations, and logics.
• Complete all responsibilities as outlined in the annual performance review and/or goal setting.
• Exceeds all Dental Claims Accuracy department yearly goals.
• Complete all special projects and other duties as assigned.
• 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 requirements of the job change.

• High School Diploma or GED required.
• Minimum of three years' work experience in a clinical role in the dental office, as a Dental Assistant or Dental Hygienist, as well as four plus years' work experience at Cotiviti and meets the responsibilities and performance requirements of a Dental Analyst II.
• Coding Dental Certification (CDC) required.
• Is proficient in current dental terminology (CDT) dental procedures, conditions, and treatment practices.
• Is proficient in dental claims payment policy and processing, specifically CDT and limited CPT.
• Ability to conduct training to both internal staff and clients in an efficient and effective manner.
• Excellent computer skills in Microsoft Word, Excel, PowerPoint, Outlook, etc.

Cognitive/Mental Requirements:

• Exceptional problem solving and analytical skills with excellent written and verbal communication with the ability to think logically and process sequentially with a high level of detailed accuracy and speed.
• Demonstrated ability to meet or exceed assigned targets and deadlines consistently with minimal supervision.
• Communicating with others to exchange information.
• Assessing the accuracy, neatness and thoroughness of the work assigned.

Working Conditions and Physical Requirements:

• Remaining in a stationary position, often standing or sitting for prolonged periods.
• Repeating motions that may include the wrists, hands, and/or fingers.
• No adverse environmental conditions expected.
• 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.

Base compensation ranges from $30.00 to $37.25 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: 5/21/2026

Applications are assessed on a rolling basis. We anticipate that the application window will close on 7/21/2026, but the application window may change depending on the volume of applications received or close immediately if a qualified candidate is selected.

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