Remote Part-Time Staff Dentist: Claims & Utilization

LIBERTY DENTAL PLAN CORPORATION; Tustin (CA); Hybrid; USD 102,000 - 113,000; Part time

Benefits offered by this job

Remote or hybrid work

401(k) plan with match

EAP program

Paid time off

Paid holidays

Job summary

Liberty Dental Plan is seeking a Staff Dentist (Part-Time) to remotely review dental claims and service requests across multiple lines of business. You will apply clinical expertise to determine coverage based on benefit plans and guidelines, while maintaining high productivity and quality standards.

The role emphasizes collaboration with providers and leadership, ongoing calibration, and participation in grievance and appeals. A DDS/DMD, active license, and 6+ years' experience are required.

Qualifications

• DDS or DMD degree from an accredited dental school.
• Active, unrestricted dental license in good standing in the U.S.
• Minimum of six (6) years as a practicing dentist.
• Experience with Medicaid and Medicare Advantage dental programs.
• Ability to manage high-volume clinical review queues with accuracy.

Responsibilities

• Review dental claims, referrals, and prior authorization requests.
• Evaluate treatment plans, radiographs, and chart notes.
• Make coverage determinations based on plans and medical necessity.
• Document clinical rationale compliant with regulations and accreditation.
• Collaborate with leadership to address complex clinical scenarios.
• Engage in calibration sessions to ensure consistency in decisions.
• Participate in grievance, appeal, and secondary review activities.
• Stay current with ADA CDT coding updates and state requirements.

Skills

DDS/DMD

Active license

6+ years practice

Medicaid/Medicare exp.

High-volume review

Credentialing requirements

Clinical guidelines

Radiographs interpretation

Computer literacy

Written communication

Education

DDS or DMD

Tools

Overjet

Job description

Liberty Dental Plan is seeking a Staff Dentist (Part-Time) to remotely review dental claims and service requests across multiple lines of business. You will apply clinical expertise to determine coverage based on benefit plans and guidelines, while maintaining high productivity and quality standards.

The role emphasizes collaboration with providers and leadership, ongoing calibration, and participation in grievance and appeals. A DDS/DMD, active license, and 6+ years' experience are required.