
1001 - 5000 employees
Founded 2002
đĽ Healthcare
đź Consulting
đŚ Logistics
Healthcare ⢠Consulting ⢠Logistics
Liberty Dental Plan is a U. S. -based dental insurance provider offering Medicaid (including Medi-Cal), Medicare Advantage, commercial, individual & family, and group dental plans across multiple states. The company operates member-facing services (find-a-dentist, member portal, mobile app, claims and eligibility tools) and provider-facing services (provider portal, network enrollment, claims submission, clinical guidelines, and value-based programs). Liberty Dental Plan focuses on dental benefits administration, provider network management, compliance and credentialing, and serving members, providers, and brokers.
đ July 22
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1001 - 5000 employees
Founded 2002
đĽ Healthcare
đź Consulting
đŚ Logistics
Healthcare ⢠Consulting ⢠Logistics
Liberty Dental Plan is a U. S. -based dental insurance provider offering Medicaid (including Medi-Cal), Medicare Advantage, commercial, individual & family, and group dental plans across multiple states. The company operates member-facing services (find-a-dentist, member portal, mobile app, claims and eligibility tools) and provider-facing services (provider portal, network enrollment, claims submission, clinical guidelines, and value-based programs). Liberty Dental Plan focuses on dental benefits administration, provider network management, compliance and credentialing, and serving members, providers, and brokers.
⢠Review dental claims, referrals, and prior authorization requests across multiple lines of business. ⢠Apply clinical expertise to evaluate treatment plans, radiographs, chart notes, and supporting documentation. ⢠Make coverage determinations based on benefit plans, clinical guidelines, medical necessity criteria, and applicable policies. ⢠Meet established productivity, quality, and turnaround-time standards. ⢠Document clinical rationale clearly and accurately in accordance with regulatory and accreditation requirements. ⢠Participate in calibration sessions to promote consistency and accuracy in clinical decision-making. ⢠Complete inter-rater reliability assessments and support ongoing quality improvement efforts. ⢠Collaborate with leadership and peers to address complex clinical scenarios and interpretation questions. ⢠Incorporate audit findings and feedback to continuously enhance determination accuracy and documentation quality. ⢠Conduct peer-to-peer consultations with treating providers regarding clinical determinations and treatment alternatives. ⢠Participate in grievance, appeal, and secondary review activities. ⢠Consult with dental specialists and subject matter experts as needed to support informed clinical decision-making. ⢠Maintain expertise in Liberty Dental Plan benefit structures and applicable Medicaid programs. ⢠Support regulatory reporting and accreditation-related activities. ⢠Stay current with ADA CDT coding updates, evidence-based treatment guidelines, and state-specific requirements. ⢠Participate in required training programs, departmental meetings, and organizational initiatives.
⢠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.
⢠Competitive pay structure and savings options to help you reach your financial goals. ⢠Excellent 401(k) retirement benefits , including employer match, Roth IRA options, immediate vesting during the Safe Harbor period, and access to professional financial advice through Financial Engines. ⢠Employee Assistance Program (EAP) to support mental health and well-being. ⢠Generous vacation and sick leave policies, with the ability to roll over unused time. ⢠Paid company holidays. ⢠Remote or hybrid work options available for various positions.
Apply Nowđ July 16
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