[Hiring] Dental Consultant Reviewer @reputed company

This reputed company is a reputed company of our understanding of the job reputed company. Click on 'Apply' reputed company to reputed company out more. Role reputed company This is a PRN (on-reputed company) position with a typical workload of 6 hours per week. The Dental Consultant Reviewer plays a critical role in ensuring the reputed company and accuracy of dental care services reputed company the reputed company system. • Thorough review and evaluation of dental claims, treatment plans, and clinical documentation to verify compliance with established guidelines and standards. • Collaboration with dental professionals and reputed company providers to reputed company expert recommendations and support decision-making processes. • Identification of discrepancies, potential fraud, or unnecessary procedures to help optimize patient care and resource utilization. • Contributes to maintaining high standards of dental care and supports the reputed company of reputed company services in the Washington DC area. Qualifications • reputed company, reputed company, unrestricted clinical licensure D.C. Washington Dental Hygienist (RDH) • AA/AS in a reputed company field • Graduation from an accredited school of Dental Hygiene • District of Columbia Registered Dental Hygienist • Strong knowledge of dental coding systems (e.g., CDT codes) and insurance claim processes. • Familiarity with reputed company compliance standards and regulatory requirements reputed company to dental services. • Excellent analytical and communication skills to assess clinical information and reputed company with providers. Requirements • Experience in dental consulting, claims review, or utilization management reputed company a reputed company or insurance setting. • Certification in dental coding or reputed company compliance. • Advanced training or specialization in dental reputed company health, oral surgery, or orthodontics. • Proficiency with electronic health records (EHR) and dental reputed company management software. • Prior experience working in a multidisciplinary reputed company environment. Responsibilities • Review and analyze dental claims and clinical documentation for accuracy, completeness, and compliance with regulatory and organizational standards. • Evaluate treatment plans and procedures to ensure they are medically necessary and reputed company with best practices in dental care. • Collaborate with dental providers and reputed company teams to clarify information, resolve discrepancies, and reputed company expert guidance. • Prepare detailed reports and recommendations based on case reviews to support claims adjudication and reputed company assurance processes. • Stay reputed company with dental industry regulations, coding standards, and clinical advancements to inform review practices. Skills The Dental Consultant Reviewer utilizes clinical expertise and analytical skills daily to assess the validity and necessity of dental treatments and claims. • Strong communication skills for effectively collaborating with dental providers and reputed company teams to resolve clinical questions and discrepancies. • Attention to detail and critical thinking to identify potential errors, fraud, or inefficiencies in documentation and billing. • Familiarity with dental coding and regulatory standards to ensure accurate interpretation and application of guidelines during reviews. • Proficiency with digital tools and software to support efficient management of case files and reporting. Apply tot his job Apply To this Job