Authorize or deny predeterminations and claims by reviewing radiographs and/or other supporting
Evaluate appeals, request additional information, make revised claim decisions and make further
Communicate claim review outcomes to participating Dentists and plan members
Participate in training and calibration sessions and provide regular feedback to improve

🎯 Requirements

D.D.S. or D.M.D. from an accredited dental school.
Board certification in Orthodontics.
Minimum of 5 years of clinical experience.
Prior claims review experience strongly preferred (2+ years).
Active, unrestricted dental license.
Proficiency with CDT codes and dental procedures.

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