JOB TITLE: Dental Peer Reviewer (must be a Licensed Dentist)

REPORTS TO: President & CEO

DEPARTMENT: Peer Review Committee

FLSA STATUS: Hourly – Non Exempt

Summary Description

Reviews patient information to ensure treatment/service provided falls within the plan guidelines and that the service was appropriate for the condition. Reviewing for positions – Dentist, Dental Hygienist and Oral Surgeon.

Specific Responsibilities include, but are not limited to:

Reviewing x-rays, patient charts and other patient records to ensure treatment/service provided is within guidelines of the plan.
Review pre-authorization paperwork to ensure the intended treatment meets the dental plan criteria and relevant program criteria.
Complete Peer Review Form for each chart reviewed

The list of responsibilities is not intended to be all-inclusive and may be expanded to include other duties that management may deem necessary, if needed.

Academic and Experience Requirements

Graduation from an accredited dental school
Valid, unexpired license to practice Dentistry in Michigan
Successful completion /passing of background check, drug screen and credential check

Other Qualifications Desired:

Ability to communicate effectively (verbal and written).
Excellent organization and interpersonal skills required.
Skilled in working with others in a team environment.
Must be proficient in MS Office applications (Word, Excel, PowerPoint)
Experience working with EMR systems- eCW preferred. Will train.

Experience

Minimum 3-5 years of experience in a clinical dental role or other similar related experience.

Knowledge of dental procedures, terminology, and codes.

Advantage Health Centers

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Peer Reviewer- Dentist, Dental Hygienist, Oral Surgeon