Remote Staff Dentist – Utilization & Claims (PT)

Liberty Dental Plan; Tustin (CA); Hybrid; USD 102,000 - 113,000; Part time

Benefits offered by this job

Remote work options

Job summary

Liberty Dental Plan is seeking a Staff Dentist (Part-Time, Remote) to review dental claims and requests with clinical precision. You will evaluate treatment plans, radiographs, and chart notes to determine coverage in alignment with benefit structures and regulatory standards.

The role requires a DDS/DMD, active license, and 6+ years of practice, including Medicaid/Medicare experience. You will participate in QA and collaborates across teams to ensure consistent determinations.

Qualifications

• DDS or DMD degree from an accredited dental school.
• Current, active, unrestricted dental license in good standing from any U.S. state or territory.
• Minimum of six years of experience as a practicing dentist.
• Experience working with Medicaid and Medicare Advantage dental programs.
• Ability to manage high-volume clinical review queues with accuracy and timeliness.

Responsibilities

• Review dental claims, referrals, and prior authorization requests across multiple lines of business.
• Apply clinical expertise to evaluate treatment plans, radiographs, chart notes, and supporting documentation.
• Make coverage determinations based on benefit plans, guidelines, and medical necessity criteria.
• Document clinical rationale clearly in accordance with regulatory requirements.
• Collaborate with leadership to address complex clinical scenarios and interpret questions.

Skills

Clinical review

Regulatory compliance

Licensure

Medicaid/Medicare

Communication

Team collaboration

Dental coding knowledge

Education

DDS or DMD degree

Active dental license

Tools

Overjet

Job description

Liberty Dental Plan is seeking a Staff Dentist (Part-Time, Remote) to review dental claims and requests with clinical precision. You will evaluate treatment plans, radiographs, and chart notes to determine coverage in alignment with benefit structures and regulatory standards.

The role requires a DDS/DMD, active license, and 6+ years of practice, including Medicaid/Medicare experience. You will participate in QA and collaborates across teams to ensure consistent determinations.