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Bureau of Dental Review, 150 Broadway
Minimum Qualifications Current registration as a licensed Dental Hygienist in New York State and three years of experience in dental hygiene practice OR graduation from a school of dentistry and one year of dental services experience. Individuals completing dental programs outside the United States must have completed a program accredited by the World Health Organization.
Knowledge of NYS Medicaid Dental Program policy and procedures. Experience in the review and evaluation of dental prior approval requests and dental claims pended for professional review.
Duties Description With the assistance and direction of a licensed dentist, the incumbent of this position will: evaluate x-rays, charting and treatment plans submitted for dental prior approval requests and make appropriate determinations within the context of the NYS Medicaid Dental Program; review and evaluate claims for payment that have been pended for professional review; interact with providers and clients to provide assistance and guidance on Medicaid policy, procedures and complaints; identify cases of inappropriate payment and request documentation and/or recoupment; provide written responses to requests for administrative fair hearings; provide oral testimony via telephone if requested by an Administrative Law Judge; supervise and provide guidance for Dental Services Review Assistant 1’s, consultant hygienists, support staff and others in the Division of Operations and Systems; provide assistance to dental consultants, Public Health Dentists and the Medicaid Dental Director.
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Notes on ApplyingSubmit resume to Human Resources Management Group, SC/90688/DSRA2, Room 2217, Corning Tower Building, Empire State Plaza, Albany, New York 12237- 0012, or by email to firstname.lastname@example.org or by fax to (518) 473-3395 with a subject line SC/90688/DSRA2. Resumes will be accepted until 12/08/2017