Michigan Licensed Dental Review Specialist

A company is looking for a Dental Review Specialist to provide expertise in reviewing Medicare and Medicaid claims on a contract basis. Key Responsibilities Perform claims coverage reviews for dental services, applying relevant rules for coverage and payment issues Coordinate with the Medical Director and contribute to contractor policy development Maintain knowledge of dental practice standards and provide expert testimony as required Required Qualifications 3 or more years as a Board certified Doctor of Dental Surgery or Doctor of Dental Medicine 3 or more years of practicing dentistry as a board-certified professional Must have an active valid and unrestricted license Prior experience in the health insurance industry or healthcare claims processing organization No adverse actions pending or taken against by any State or Federal licensing board or program

Apr 9, 2025 - 06:57

A company is looking for a Dental Review Specialist to provide expertise in reviewing Medicare and Medicaid claims on a contract basis. Key Responsibilities Perform claims coverage reviews for dental services, applying relevant rules for coverage and payment issues Coordinate with the Medical Director and contribute to contractor policy development Maintain knowledge of dental practice standards and provide expert testimony as required Required Qualifications 3 or more years as a Board certified Doctor of Dental Surgery or Doctor of Dental Medicine 3 or more years of practicing dentistry as a board-certified professional Must have an active valid and unrestricted license Prior experience in the health insurance industry or healthcare claims processing organization No adverse actions pending or taken against by any State or Federal licensing board or program