Dental Consultant (Dentist) - Cigna Healthcare - Remote

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Requirements:

• Must maintain an active dental license to practice dentistry in the state of employment.
• Minimum of five (5) years of experience in private dental practice.
• Thorough knowledge of oral health care and dental standards of practice.
• Experience with professional claim review is highly preferred.
• Excellent oral and written communication skills.
• Proficient in Microsoft Word, Excel, PowerPoint, and Outlook.
• Strong analytical and problem-solving skills.

Responsibilities:

• Review dental claims and predetermination treatment plans to ensure compliance with plan provisions.
• Analyze radiographic images, chart notes, and other diagnostics for clinical documentation adequacy.
• Handle appeal requests and provide timely clinical responses.
• Identify trends and educational needs in dental care practices.