New Jersey Licensed Staff Dentist
VirtualVocations
Seeking a New Jersey Licensed Staff Dentist, the full-time remote position will manage clinical reviews of dental claims and prior authorizations, ensuring compliance with coverage guidelines while collaborating with clinical leaders to improve quality initiatives. Key responsibilities Review dental claims and prior authorization requests to ensure accurate determinations based on coverage guidelines Participate in calibration sessions and interrater reliability assessments to maintain clinical consistency Conduct peer-to-peer consultations with providers regarding clinical decisions and support grievance and appeal reviews Required qualifications DDS or DMD from an accredited institution Active, unrestricted New Jersey dental license in good standing Minimum 6 years of experience as a practicing dentist Experience with claims review, utilization management, or quality initiatives preferred Strong clinical judgment and ability to interpret dental radiographs and clinical records
Vacancy posted 4 hours ago
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