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Dental Consultant - Full-time / Part-time
•30 days ago
| Hours | Full-time, Part-time |
|---|---|
| Location | Orange, CA Orange, California |
About this job
Position Summary:
Performs clinical chart review of staff model and IPA dental charts. Provides mentoring to WDS employed and contracted dentists.
Reporting Relationship:
The Dental Consultant reports to the Dental Director.
Major Accountabilities:
* Reviews dental charts for potential quality issues.
* Reviews referral, pre-authorizations and claims requests for appropriate approval or denial of benefits.
* Review of patient/member grievances and assistance with preparing resolutions.
* Participates in committees and activities related to credentialing, peer review, quality improvement, utilization review and others, as needed.
* Provides clinical mentoring to WDS employed and contracted dentists.
Requirements
Experience Requirement
* 5 year minimum clinical experience.
* Must have and continuously maintain an active unencumbered CA dental license.
* CADP Certified Auditor
Necessary Skill Sets
* Excellent verbal and written communication.
* Ability to work in a regulatory environment with very strict timeliness and accuracy requirements.
* Dedication to excellent service.
* Ability to work in a fast paced, professional environment.
* Ability to meet required deadlines.
Proficient use of Microsoft Office (Excel, Word and Outlook).
The above is intended to describe the general content of and requirements for the performance of this job. It is not to be construed as an exhaustive statement of duties, responsibilities or requirements.
Performs clinical chart review of staff model and IPA dental charts. Provides mentoring to WDS employed and contracted dentists.
Reporting Relationship:
The Dental Consultant reports to the Dental Director.
Major Accountabilities:
* Reviews dental charts for potential quality issues.
* Reviews referral, pre-authorizations and claims requests for appropriate approval or denial of benefits.
* Review of patient/member grievances and assistance with preparing resolutions.
* Participates in committees and activities related to credentialing, peer review, quality improvement, utilization review and others, as needed.
* Provides clinical mentoring to WDS employed and contracted dentists.
Requirements
Experience Requirement
* 5 year minimum clinical experience.
* Must have and continuously maintain an active unencumbered CA dental license.
* CADP Certified Auditor
Necessary Skill Sets
* Excellent verbal and written communication.
* Ability to work in a regulatory environment with very strict timeliness and accuracy requirements.
* Dedication to excellent service.
* Ability to work in a fast paced, professional environment.
* Ability to meet required deadlines.
Proficient use of Microsoft Office (Excel, Word and Outlook).
The above is intended to describe the general content of and requirements for the performance of this job. It is not to be construed as an exhaustive statement of duties, responsibilities or requirements.