Part-Time Dentist - Utilization & Claims Specialist

LIBERTY DENTAL PLAN CORPORATION; Tustin, Nevada (CA, IA); Hybrid; USD 101,942 - 112,963; Part time

Benefits offered by this job

401(k) with employer match

Employee assistance program

Paid holidays

20 hours per week

Job summary

Liberty Dental Plan Corporation in Nevada is seeking a Staff Dentist to support utilization management and review programs by evaluating dental claims, prior authorizations, referrals, and treatment requests across multiple payer lines. You will apply clinical expertise to determine coverage based on guidelines, regulatory requirements, and policies, while meeting productivity and quality standards.

The role supports calibration and peer collaboration with a 20-hour workweek and part-time

Qualifications

• DDS or DMD from an accredited dental school.
• Current, active Nevada dental license in good standing.
• Minimum of six (6) years of experience as a practicing dentist.
• Ability to complete Liberty Dental Plan credentialing requirements.
• Knowledge of dental procedures, coding, and medical necessity criteria.

Responsibilities

• Review dental claims, referrals, and prior authorization requests across multiple lines of business.
• Apply clinical expertise to evaluate treatment plans, radiographs, and chart notes.
• Make coverage determinations based on benefit plans and guidelines.
• Document clinical rationale in compliance with regulatory requirements.

Skills

Communication skills

Clinical decision making

Regulatory knowledge

Collaboration

Education

DDS or DMD

Nevada dental license

Job description

Liberty Dental Plan Corporation in Nevada is seeking a Staff Dentist to support utilization management and review programs by evaluating dental claims, prior authorizations, referrals, and treatment requests across multiple payer lines. You will apply clinical expertise to determine coverage based on guidelines, regulatory requirements, and policies, while meeting productivity and quality standards.

The role supports calibration and peer collaboration with a 20-hour workweek and part-time