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Dental Consultant (Clinical Screening and Compliance)
Location:
Roseville, CA
Description:
Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development. Summary Gainwell Technologies Dental Consultants apply clinical expertise to review, approve, and/or deny dental treatment authorization requests and claims in accordance with CA Department of Health Care Services (DHCS) Medi:Cal Dental policies. Your role in our mission:Manually review of claims, Treatment Authorization Requests (TARs) and related documents for California Medi:Cal members for adjudication, ensuring adherence to Medi:Cal Dental policies and procedures.:Work within a team of dental consultants, sharing a proportional workload of claims processing and adjudication that have been determined to need professional expertise of an experienced dentist. These claims have been referred from other members of the Claims Processing team, and good communication skills are necessary for continuity within the business operations.:When needed, dental consultants assist with training and orientation of new dental consultants, providing guidance and mentoring, such as job shadowing and coaching.:Assist fellow dental consultants with complex cases or claims needing a second opinion, including collaboration for cases involving Medi:Cal Dental Program special needs populations.:Assist other departments, when requested: a) Claims Processing and Operations, b) Provider and Member Services, c) Grievances/Appeals, d) HR/Onboarding/Interviews, e) Quality Management, f) peer review, and g) referral to/review of findings/adjudication of claims related to Clinical Screening dentist evaluations. What were looking for typedisc::A minimum of ten (10) years of prior hands:on, clinical experience as a dentist delivering dental services within a general or recognized dental specialty practice.:Possession of active (non:expired) license to practice dentistry in CA, which is in good:standing and free of any suspensions or sanctions from Federal, State, or local jurisdictions.:Minimum of two (2) years working within an organization that provides Medi:Cal Dental services to patients. Prior adjudication and claims processing for the Medi:Cal Dental Program in California is a plus, but not a requirement.:Demonstrated expertise and knowledge of Medi:Cal Dental criteria and program requirements.:Position will be required to be On:site (Roseville, CA), with possible Hybridschedules (Tuesday :Thursday in office).: Good interpersonal and presentation skills. What you should expect in this role: This isa hybrid work environment with 2:3days a week in the office and as needed with the remainder of time remote work. The office is located in Roseville(Sacramento, California area) :Former Delta Dental employees are allowed to work for up to 2 years in a remote (work from home) environment:Full:time (40 hours per week) salaried employee:Flexible and customizable benefit package, which is explained in new hire orientation. :In order to effectively work some days from homewith Gainwell, employees Broadband Internet connections, should have a minimum speed of 24MBS download and 8 MBS upload. Greater speeds will of course provide better performance. :To Test your internet download and upload speed::Go to Google:Search for Internet Speed Testor click here. LI:NB1 LI:HYBRID The pay range for this position is116,100.00:140,000 per year, however, the base pay offered may vary depending on geographic region, internal equity, job:related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You'll have the opportunity to grow your career in a compan
Posted:
April 4 on Tip Top Job
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More About this Listing: Dental Consultant (Clinical Screening and Compliance)
Dental Consultant (Clinical Screening and Compliance) is a Consulting Jobs Consultant Job located in Roseville CA. Find other listings like Dental Consultant (Clinical Screening and Compliance) by searching Oodle for Consulting Jobs Consultant Jobs.
Dental Consultant (Clinical Screening and Compliance) is a Consulting Jobs Consultant Job located in Roseville CA. Find other listings like Dental Consultant (Clinical Screening and Compliance) by searching Oodle for Consulting Jobs Consultant Jobs.