Dental Compliance Manager:
Location: Multiple Southern California Locations (Travel Required)
About us:
We are a rapidly growing multi-location dental organization committed to delivering exceptional patient care while maintaining the highest standards of clinical excellence, ethical business practices, and regulatory compliance. We are seeking a highly organized, detail-oriented Dental Compliance Manager to oversee compliance, documentation, billing accuracy, and risk management across our practices.
Essential Responsibilities:
Clinical Documentation & Chart Audits
Conduct routine and random chart audits across all practice locations.
Review clinical documentation for completeness and accuracy.
Verify SOAP notes support all procedures performed.
Ensure diagnoses support treatment rendered.
Confirm periodontal charting, radiographs, CBCT scans, photographs, and diagnostic records support treatment.
Audit treatment sequencing and clinical justification.
Verify referrals, follow-up documentation, and supporting clinical records.
Identify deficiencies and implement corrective action plans.
Treatment Plan & Consent Compliance
Ensure patient records contain all required documentation, including:
Signed treatment plans
Updated treatment plans when treatment changes
Informed consent forms
Surgical, extraction, implant, grafting, sedation, and orthodontic consents
HIPAA acknowledgments
Privacy notices
Financial agreements
Required doctor and patient signatures
Proper dates corresponding to treatment provided
Insurance Billing Compliance
Audit insurance claims for coding and documentation accuracy.
Verify CDT coding is appropriate.
Ensure billed procedures match clinical documentation.
Review narratives, radiographs, and supporting documentation.
Audit crowns, implants, periodontal procedures, oral surgery, endodontics, prosthodontics, and restorative treatment.
Identify duplicate billing, miscoding, overbilling, underbilling, and billing inconsistencies.
Verify insurance adjustments and contractual write-offs.
Delta Dental Compliance
The Dental Compliance Manager will:
Ensure strict compliance with all Delta Dental provider agreement requirements.
Verify contracted fee schedules are correctly applied.
Ensure patient cost-sharing is calculated accurately.
Prevent prohibited balance billing and contractual violations.
Audit claims to ensure documentation supports billed procedures.
Review reimbursements, adjustments, and write-offs for accuracy.
Educate providers and staff on Delta Dental policies and contractual obligations.
Reduce the risk of audits, recoupments, and provider sanctions.
Denti-Cal (Medi-Cal Dental) Compliance
One of our practice locations participates as an in-network Denti-Cal provider. Responsibilities include:
Audit Denti-Cal claims for coding and billing accuracy.
Verify eligibility, authorizations, and supporting documentation.
Ensure services billed meet Denti-Cal coverage and documentation requirements.
Prevent duplicate billing, unbundling, and other billing errors.
Prepare the office for Denti-Cal audits and implement corrective actions when necessary.
Financial Compliance
Review all financial documentation, including:
Third-party financing agreements (CareCredit, Proceed Finance, Cherry, etc.)
Signed financing contracts and sales receipts
Patient payment plans
Credit card authorization forms
Refund documentation
Financial agreements
** Required **
Minimum of 5 years of experience in dental practice management, compliance, insurance auditing, billing, or clinical administration.
Thorough understanding of California Dental Board regulations.
Strong knowledge of dental insurance billing and CDT coding.
Experience auditing patient records and documentation.
Knowledge of HIPAA, OSHA, and dental compliance standards.
Excellent organizational, analytical, and communication skills.
Ability to travel between multiple practice locations.
Experience with Denticon or similar dental practice management software.
98%+ documentation accuracy
100% informed consent compliance
100% signed third-party financing documentation
Insurance claim error rate below 2%
Reduction in insurance recoupments
Reduction in Dental Board complaints
Reduction in patient refund requests due to documentation deficiencies
Completion of monthly compliance audits
Office compliance scores consistently above 95%
Looking forward to reviewing your qualifications!
Pay: $60,000.00 - $90,000.00 per year
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
Work Location: In person
