Remote Staff Dentist: Claims & Utilization Review

LIBERTY Dental Plan; New York (NY); On-site; USD 150,000 - 165,000; Full time

Job summary

LIBERTY Dental Plan seeks a New York Licensed Staff Dentist for a fully remote role focused on utilization management and clinical review. You will review dental claims and prior authorizations, interpret records, and apply coverage guidelines to ensure medical necessity and appropriate care across commercial and government programs.

This role emphasizes collaboration with clinical leaders, calibration sessions, peer reviews, and regulatory-compliant documentation.

Qualifications

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

Responsibilities

• Utilization Management & Clinical Review: review dental claims and prior authorizations.
• Calibration & Clinical Consistency: participate in calibration sessions and peer discussions.
• Provider Engagement & Peer Review: conduct peer-to-peer consultations and support reviews.
• Training, Collaboration & Compliance: participate in trainings and regulatory reporting.

Skills

Clinical judgment

Interpret radiographs

Regulatory knowledge

Written communication

Remote work discipline

Education

DDS or DMD from an accredited institution

Tools

AI-supported tools

Job description

LIBERTY Dental Plan seeks a New York Licensed Staff Dentist for a fully remote role focused on utilization management and clinical review. You will review dental claims and prior authorizations, interpret records, and apply coverage guidelines to ensure medical necessity and appropriate care across commercial and government programs.

This role emphasizes collaboration with clinical leaders, calibration sessions, peer reviews, and regulatory-compliant documentation.