What are the responsibilities and job description for the Dental Claims Review Specialist - Evansville position at ProMedica?
Location:
HRI DentalDepartment:
Health ServicesWeekly Hours:
5Status:
Part timeShift:
Days (United States of America)Job Summary:
As a member of the Dental Review Team (DRT), you ensure quality control in terms of determining standard of care, appropriate planlimitations 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