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Dental Consultant (Dentist) : Roseville, California
Location:
Roseville, CA
Description:
It takes great medical minds to create powerful solutions that solve some of healthcare's most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you've honed your career in a fast:moving medical environment. While Gainwell operates with a sense of urgency, you'll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values work:life balance, continuous 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: 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.: Willingness to travel if needed What you should expect in this role: This is a fully remote position for the first year of service then the employee is expected to work a hybrid schedule. : Candidates must be willing to work in ouroffice located in Roseville(Sacramento, California area) on Tuesday through Thursday each week as a part of our hybrid schedule.: Full:time (40 hours per week) salaried employee status with pay twice a month.: No probationary period. Regular employee status on first day of work.: Benefits starting on first day of employment. : Paid Time Off (vacation, holidays, and sick time): Health benefits (medical, dental, vision): You must be available to work Monday through Friday between 8 AM to 6 PM to total 8 hours per day.: In order to effectively work fully remotely or hybridwith Gainwelleach Monday and Friday, 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 toGoogle: Search for Interne
Posted:
May 7 on Tip Top Job
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More About this Listing: Dental Consultant (Dentist) : Roseville, California
Dental Consultant (Dentist) : Roseville, California is a Nurse & Healthcare Dentist Job located in Roseville CA. Find other listings like Dental Consultant (Dentist) : Roseville, California by searching Oodle for Nurse & Healthcare Dentist Jobs.
Dental Consultant (Dentist) : Roseville, California is a Nurse & Healthcare Dentist Job located in Roseville CA. Find other listings like Dental Consultant (Dentist) : Roseville, California by searching Oodle for Nurse & Healthcare Dentist Jobs.