Staff Dentist, Independent Contractor
Location
California
Posted
6 days ago
Salary
0
Seniority
Lead
Job Description
Staff Dentist, Independent Contractor
Liberty Dental Plan
• Perform timely clinical adjudication of dental claims and prior authorization requests • Determine medical necessity and benefit coverage using clinical expertise and plan guidelines • Interpret radiographs, charts, and supporting documentation to inform decisions • Identify inappropriate, unnecessary, or low-value services • Participate in quality improvement initiatives, audits, and utilization analyses • Conduct focused chart reviews to identify utilization trends and potential quality concerns • Support SIU activities, including provider site reviews and corrective recommendations • Analyze treatment patterns and recommend improvements • Conduct peer-to-peer consultations with network providers • Participate in grievance, appeal, and secondary review processes • Collaborate with specialists or subject-matter experts as needed • Participate in calibration sessions, trainings, and interrater reliability activities • Attend clinical and operational meetings • Contribute to credentialing and quality committees • Provide clinical input during tele-dentistry consultations when needed • Maintain expertise in dental benefit plans and Medicaid program requirements • Support regulatory reporting and compliance initiatives
Job Requirements
- DDS or DMD from an accredited dental school
- Active, unrestricted dental license in good standing in a U.S. state
- Minimum: 4+ years practicing as a dentist
- 2+ years experience with claims review, utilization management, or payer-side dentistry preferred
- Strong knowledge of: Dental coding and clinical guidelines
- Managed care and reimbursement systems
- Medical necessity criteria and adjudication processes
- Ability to interpret radiographs and dental records
- Strong analytical, decision-making, and communication skills
- Current professional malpractice insurance required (must be maintained throughout the contract period)
Benefits
- Fully remote opportunity with flexible scheduling
- Opportunity for contract extension based on performance and business needs
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