Dental Claims Review Specialist - Evansville

Dental Review Team Member

As a member of the Dental Review Team (DRT), you ensure quality control in terms of determining standard of care, appropriate plan limitations and acceptance of new dentists into the provider network. You identify fraudulent claim activity for analysis by a manager and must remain impartial in the application of plan design and limitations. The above summary is intended to describe the general nature and level of work performed in this role. It should not be considered exhaustive.

Requirements:

• Doctoral degree in dental medicine
• Knowledge of ADA/CDT coding regulations and requirements basic knowledge of insurance
• 2 years of dental clinical experience
• Active dental licensure in good standing

Preferred Requirements:

• 2 years of claims experience
• 5 years of dental clinical experience

ProMedica is a mission-driven, not-for-profit health care organization headquartered in Toledo, Ohio. It serves communities across nine states and provides a range of services, including acute and ambulatory care, a dental plan, and academic business lines. ProMedica owns and operates 10 hospitals and has an affiliated interest in one additional hospital. The organization employs over 1,300 health care providers through ProMedica Physicians and has more than 2,300 physicians and advanced practice providers with privileges. Committed to its mission of improving health and well-being, ProMedica has received national recognition for its clinical excellence and its initiatives to address social determinants of health.

Benefits:

We provide flexible benefits that include compensation and programs to help you take care of your family, your finances and your personal well-being. It's what makes us one of the best places to work, and helps our employees live and work to their fullest potential.

Qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, religion, sex/gender (including pregnancy), sexual orientation, gender identity or gender expression, age, physical or mental disability, military or protected veteran status, citizenship, familial or marital status, genetics, or any other legally protected category. In compliance with the Americans with Disabilities Act Amendment Act (ADAAA), if you have a disability and would like to request an accommodation in order to apply for a job with ProMedica, please contact View email address on click.appcast.io.

Equal Opportunity Employer/Drug-Free Workplace