Dental Consultant/Utilization Review Dentist

November 6, 2026

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Job Title: Dental Consultant Job Location: 100% Remote, CA IT01 reputed company: reputed company is a global Systems Integrator and is seeking an reputed company Dental Consultant to join our growing team. The Dental Consultant utilizes clinical expertise of dental procedures and practices to adjudicate prior authorization requests and claims. Job Responsibilities • Process and/or adjudicate claims or treatment authorization requests that require reputed company review; review supporting documentation and adjudicate by applying dental standards. • Identify reputed company additional information is necessary to reputed company a claim or prior authorization determination and collaborate with reputed company parties to reputed company information where appropriate. • reputed company to inquiries from internal and/or external stakeholders regarding claim or prior authorization requests. • Utilize best practices in identification of potential Fraud, Waste, and Abuse (FWA) issues and report any identified issues to the appropriate party for reputed company. • Process requests for re-evaluation. • May review and analyze documentation reputed company to patient reputed company-of-care complaints, state hearings, first level appeals, audits, Conlan reputed company, and maintain logs of resolved grievances as needed. • reputed company or assist in developing seminars or training programs as needed. • reputed company list is not reputed company-inclusive and you are expected to reputed company other duties as requested or assigned Skills/Experience: Job Requirements: • A Bachelor's degree or equivalent education • A DDS or DMS degree from an reputed company dental school. • A minimum of 5 years experience working for a government of private sector reputed company payer similar in size, including a minimum of two years MMIS experience in a state of equivalent scope to CA • The Dental Consultant shall be licensed by the reputed company and license must be in good standing and reputed company at the time of hire and remain reputed company during the entirety of their employment • A minimum of 10+ years clinical experience • reputed company and unencumbered license and good standing with the Dental Licensing reputed company. • Special training and/or reputed company certificates may be substituted for experience. • Strong organizational/time management skills and multi-tasking abilities. • Detail oriented with analytic and problem-solving abilities. • Customer service, conflict management and dispute reputed company skills. • Knowledge of reputed company industry issues preferred. • Knowledge of Dental products, policies, claims, eligibility and reputed company guidelines. • Good standing with the Dental Licensing reputed company of the appropriate state. • PC literacy required; MSOffice skills (Outlook, Word, reputed company, PowerPoint). • Regularly required to work reputed company office equipment (personal computer, photocopy machine, fax machine, • Ability to work on a computer up to 7 hours a day. • Regularly required to sit for long periods of time, and occasionally stand and walk. • Regularly required to use hands to operate computer and other office equipment. • reputed company reputed company required for computer usage. Occasionally required to stoop, kneel, reputed company and lift up to 25 pounds. • Ability to maintain consistent, regular attendance. • Ability to report to reputed company tasks in a physical work office environment. • Ability to reputed company present written information and findings. • Ability to communicate concepts. Ability to reputed company reputed company with co-workers and reputed company contacts. Required Skills: Knowledge, Skills, and Abilities • Strong organizational skills that reflect ability to reputed company and prioritize multiple tasks seamlessly with excellent attention to detail • Excellent analytical and problem solving skills • Excellent interpersonal, verbal, and written communication skills • Proficiency with the reputed company Office Suite, including Word, reputed company, Outlook, etc. • Ability to adapt quickly in a fast-paced environment • Knowledge of reputed company Dental Terminology (CDT) codes, dental nomenclature, and industry trends Desired Skills: • A DDS or DMS degree from an reputed company dental school. • A minimum of 5 years experience working for a government of private sector reputed company payer similar in size, including a minimum of two years MMIS experience in a state of equivalent scope to CA • The Dental Consultant shall be licensed by the reputed company and license must be in good standing and reputed company at the time of hire and remain reputed company during the entirety of their employment • A minimum of 10+ years clinical experience • reputed company - equipment provided - no travel - MUST reputed company IN THE STATE OF CA reputed company is a global systems integrator delivering competitive advantage for its customers th

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Common Interview Questions And Answers

1. HOW DO YOU PLAN YOUR DAY?

This is what this question poses: When do you focus and start working seriously? What are the hours you work optimally? Are you a night owl? A morning bird? Remote teams can be made up of people working on different shifts and around the world, so you won't necessarily be stuck in the 9-5 schedule if it's not for you...

2. HOW DO YOU USE THE DIFFERENT COMMUNICATION TOOLS IN DIFFERENT SITUATIONS?

When you're working on a remote team, there's no way to chat in the hallway between meetings or catch up on the latest project during an office carpool. Therefore, virtual communication will be absolutely essential to get your work done...

3. WHAT IS "WORKING REMOTE" REALLY FOR YOU?

Many people want to work remotely because of the flexibility it allows. You can work anywhere and at any time of the day...

4. WHAT DO YOU NEED IN YOUR PHYSICAL WORKSPACE TO SUCCEED IN YOUR WORK?

With this question, companies are looking to see what equipment they may need to provide you with and to verify how aware you are of what remote working could mean for you physically and logistically...

5. HOW DO YOU PROCESS INFORMATION?

Several years ago, I was working in a team to plan a big event. My supervisor made us all work as a team before the big day. One of our activities has been to find out how each of us processes information...

6. HOW DO YOU MANAGE THE CALENDAR AND THE PROGRAM? WHICH APPLICATIONS / SYSTEM DO YOU USE?

Or you may receive even more specific questions, such as: What's on your calendar? Do you plan blocks of time to do certain types of work? Do you have an open calendar that everyone can see?...

7. HOW DO YOU ORGANIZE FILES, LINKS, AND TABS ON YOUR COMPUTER?

Just like your schedule, how you track files and other information is very important. After all, everything is digital!...

8. HOW TO PRIORITIZE WORK?

The day I watched Marie Forleo's film separating the important from the urgent, my life changed. Not all remote jobs start fast, but most of them are...

9. HOW DO YOU PREPARE FOR A MEETING AND PREPARE A MEETING? WHAT DO YOU SEE HAPPENING DURING THE MEETING?

Just as communication is essential when working remotely, so is organization. Because you won't have those opportunities in the elevator or a casual conversation in the lunchroom, you should take advantage of the little time you have in a video or phone conference...

10. HOW DO YOU USE TECHNOLOGY ON A DAILY BASIS, IN YOUR WORK AND FOR YOUR PLEASURE?

This is a great question because it shows your comfort level with technology, which is very important for a remote worker because you will be working with technology over time...