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.
