Staff Dentist (Part-Time, Remote, Nevada License)
$153,920–$170,560 year
RemoteNevada, United States
Job Summary
Review dental claims, referrals, and prior authorization requests across Commercial, Marketplace, Medicare, and Medicaid populations by evaluating treatment plans, radiographs, and clinical documentation. Make coverage determinations based on benefit plans, clinical guidelines, and medical necessity criteria while meeting productivity and turnaround-time standards. Document clinical rationale accurately and participate in calibration sessions, peer-to-peer consultations, and grievance appeals to ensure consistent, evidence-based care. Maintain expertise in Liberty Dental Plan benefit structures and regulatory requirements while supporting quality improvement initiatives.
Required Qualifications
- DDS or DMD degree from an accredited dental school
- Current, active, and unrestricted Nevada dental license in good standing
- Minimum of six (6) years of experience as a practicing dentist
- Ability to successfully complete Liberty Dental Plan credentialing and recredentialing requirements
- Strong knowledge of dental procedures, clinical guidelines, coding standards, and medical necessity criteria
- Ability to review and interpret dental radiographs, treatment plans, and chart documentation
- Excellent written and verbal communication skills
- Ability to manage review volumes efficiently while maintaining quality and compliance standards
Desired Qualifications
- Experience in dental claims review, utilization management, managed care, or payer environments
- Experience training, coaching, or mentoring clinical peers
- Familiarity with claims adjudication systems and clinical review platforms
- Experience with AI-assisted review technologies such as Overjet or similar solutions
- Exposure to project management and quality improvement initiatives
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