New Jersey Licensed Staff Dentist

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