Dental Claims Review Specialist - Evansville
ProMedica•Evansville, IN
•Onsite
About The Position
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
Nice To Haves
- 2 years of claims experience
- 5 years of dental clinical experience
Responsibilities
- Ensure quality control in terms of determining standard of care
- Ensure quality control in terms of determining appropriate plan limitations
- Ensure quality control in terms of determining acceptance of new dentists into the provider network
- Identify fraudulent claim activity for analysis by a manager
- Remain impartial in the application of plan design and limitations
Benefits
- Flexible benefits that include compensation and programs to help you take care of your family, your finances and your personal well-being.
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What This Job Offers
Job Type
Part-time
Career Level
Mid Level
Education Level
Ph.D. or professional degree
