Job Summary
A company is looking for a Dental Consultant - Clinical Review.
Key Responsibilities
- Process and adjudicate claims or treatment authorization requests based on dental standards
- Collaborate with internal and external parties to gather additional information as needed
- Identify and report potential Fraud, Waste, and Abuse (FWA) issues
Required Qualifications
- Active Texas Dental License
- DDS or DMD degree from an accredited dental school
- Minimum of 5 years of private dentistry practice experience
- Bachelor's degree or higher
- Knowledge of Current Dental Terminology (CDT) codes and industry trends
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