Texas Licensed Clinical Review Dentist

Job Summary

Supporting the dental director in claims review, the part-time Texas Licensed Clinical Review Dentist will work remotely to review claims and clinical data, interpret radiographs, and communicate with provider offices while maintaining performance metrics.

Key responsibilities:

• Review claims and supporting clinical data for accurate documentation
• Interpret radiographs, intra-oral photographs, and clinical narratives
• Communicate with provider offices regarding adverse clinical determinations and manage individual queue assignments

Required qualifications:

• Dental degree from an Accredited Dental School
• Active dental license
• 7+ years of experience in clinical dentistry
• 3+ years of dental benefit plan experience with exposure to claim review
• Ability to pass a credentialing review for practice experience