Reviewing Dentist (Part-time)

Guardian has an opportunity for a Reviewing Dentist where you will be responsible for maintaining a set clinical review schedule of 20-32 hours per week (hours between 6am-7pm PST Monday-Friday), with expected 24-48-hour turnaround time for items available for clinical review and peer to peer phone calls.

You are

An experienced dental professional with leadership skills who demonstrates the courage to make difficult decisions and have candid conversations. You are a leader who sets and achieves high performance standards by continuously striving to provide outstanding/professional customer service. In this role, you are able to express oneself in an open and honest manner while demonstrating self-awareness and embracing feedback.

You will

• Provide clinical review of predeterminations, claims, and/or appeals by accurately reviewing radiographs and/or other diagnostic information to determine claim decision in accordance with Guardian clinical guidelines. May also include other responsibilities, such as completion of assigned Peer to Peer calls, participation in panel review of clinical determinations, completion of Clinical Grievance reviews, and participation in credentialing meetings​
• Be responsible for maintaining quality work ensuring that review determinations are sound and supported by the diagnostic materials submitted and in accordance with Guardian Clinical Policies. Success in this role will be measured based on a combination of production and quality metrics
• Support implementation of any new clinical review policy/criteria recommended by Dental Officer, Dental Standards & Quality Management and maintain awareness of continuous updates as pertaining to clinical review

You have

• Degree from ADA approved dental school
• Minimum 10 years clinical practice
• Licensed dentist in a minimum of one state
• Demonstrated communication skills
• Proven computer skills with proficiency in Windows-based programs; including, but not limited to Outlook, Teams, Internet Explorer, and Chrome
• In-depth knowledge of CDT codes, procedures, and dental insurance concepts
• Strong knowledge of Guardian dental clinical policies and guidelines, preferred
• Ability to manage multiple workloads with multiple deliverables
• Experience adapting to changing business priorities and environments

Location

​​This is a mobile (fully remote) position with set days and hours.

Salary Range:

The salary range reflected above is a good faith estimate of base pay for the primary location of the position. The salary for this position ultimately will be determined based on the education, experience, knowledge, and abilities of the successful candidate. In addition to salary, this role may also be eligible for annual, sales, or other incentive compensation.

Our Promise

At Guardian, you’ll have the support and flexibility to achieve your professional and personal goals.  Through skill-building, leadership development and philanthropic opportunities, we provide opportunities to build communities and grow your career, surrounded by diverse colleagues with high ethical standards.

Inspire Well-Being

As part of Guardian’s Purpose – to inspire well-being – we are committed to offering contemporary, supportive, flexible, and inclusive benefits and resources to our colleagues. Explore our company benefits at www.guardianlife.com/careers/corporate/benefits. Benefits apply to full-time eligible employees. Interns are not eligible for most Company benefits.

Equal Employment Opportunity

Guardian is an equal opportunity employer. All qualified applicants will be considered for employment without regard to age, race, color, creed, religion, sex, affectional or sexual orientation, national origin, ancestry, marital status, disability, military or veteran status, or any other classification protected by applicable law.

Accommodations

Guardian is committed to providing access, equal opportunity and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities. Guardian also provides reasonable accommodations to qualified job applicants (and employees) to accommodate the individual's known limitations related to pregnancy, childbirth, or related medical conditions, unless doing so would create an undue hardship. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact applicant_accommodation@glic.com.

Current Guardian Colleagues: Please apply through the internal Jobs Hub in Workday.