Remote Staff Dentist - Claims & Utilization Review

LIBERTY DENTAL PLAN CORPORATION; Nevada, Tustin (IA, CA); Hybrid; USD 150,000 - 165,000; Full time

Benefits offered by this job

401(k) retirement benefits

Dental coverage for employee andDepend

Vision insurance

Life and AD&D insurance

Wellness programs

Remote work option

Job summary

LIBERTY Dental Plan is seeking a Nevada/California licensed Staff Dentist to join our remote team. You will review claims and prior authorizations to ensure medical necessity and accurate determinations while upholding regulatory standards.

You will collaborate with Utilization Management, Claims, and Dental Directors, participate in calibration, and contribute to quality initiatives, with a competitive six-figure salary and comprehensive benefits.

Qualifications

• DDS or DMD from an accredited institution.
• Active, unrestricted Nevada and California dental license in good standing (required).
• Minimum 6 years of experience as a practicing dentist.
• Experience with claims review, utilization management, or quality initiatives preferred.

Responsibilities

• Review dental claims and prior authorization requests, applying coverage guidelines and benefit plan policies to ensure accurate determinations.
• Interpret dental records, radiographs, and clinical documentation to assess medical necessity.
• Meet established productivity and quality benchmarks for clinical reviews.
• Document clear, concise clinical rationale aligned with regulatory and accreditation standards.
• Participate in calibration sessions and interrater reliability assessments.

Skills

Clinical judgment

Interpret radiographs

Regulatory knowledge

Written communication

AI-assisted platforms

Education

DDS or DMD

Tools

AI platforms

Job description

LIBERTY Dental Plan is seeking a Nevada/California licensed Staff Dentist to join our remote team. You will review claims and prior authorizations to ensure medical necessity and accurate determinations while upholding regulatory standards.

You will collaborate with Utilization Management, Claims, and Dental Directors, participate in calibration, and contribute to quality initiatives, with a competitive six-figure salary and comprehensive benefits.