New Jersey Licensed Staff Dentist

Job Summary

A company is looking for a Staff Dentist to join their team.

Key Responsibilities

• Conduct clinical reviews of claims and pre-authorizations to ensure compliance with regulatory timeframes
• Participate in quality management activities and provide recommendations to resolve provider trends
• Conduct peer-to-peer calls and secondary reviews, identifying quality issues in claims submissions

Required Qualifications

• Active, unrestricted DDS/DMD license to practice dentistry in New Jersey or California
• Minimum of 4 years of experience as a practicing dentist
• 2 years of experience in processing claims in accordance with policy
• Knowledge of clinical dentistry procedure codes and adjudication guidelines
• Ability to be credentialed and re-credentialed by the organization