California Licensed Dental Consultant

Job Summary

To support Medi-Cal Dental services, the full-time California Licensed Dental Consultant will review and adjudicate treatment authorization requests and claims, collaborating with a team of dental consultants while working remotely with occasional onsite presence in Roseville, CA.

Key responsibilities

• Review claims and Treatment Authorization Requests (TARs) to ensure compliance with Medi-Cal Dental policies
• Collaborate with a team to manage a shared workload of claims requiring dental expertise
• Assist in training and mentoring new dental consultants through guidance and job shadowing

Required qualifications

• Active California dental license in good standing with no restrictions or sanctions
• Minimum of 10 years of clinical experience in general dentistry or a recognized dental specialty
• At least 2 years of experience in an organization providing Medi-Cal Dental services
• Demonstrated knowledge of Medi-Cal Dental criteria and program requirements
• California residency required