Minimum Qualifications License to practice dentistry in New York State and four (4) years of experience in the
practice of dentistry.
Experience in the review of dental records to determine appropriateness and quality of
services, and compliance with established standards; basic computer skills including MS Word
and experience in the preparation of narrative reports. The preferred candidate must have
excellent written and oral communication skills.
Duties Description Responsibilities may include some or all of the following: review and make determinations on
Medicaid prior approval requests received for dental services; review, evaluate, resolve, and
adjudicate dental claims pended for manual review; respond to questions from health care
providers concerning Medicaid policies and guidelines; respond to questions including
resolution of complaints; conduct audits and reviews of Medicaid providers to ensure
compliance with program requirements; identify aberrant practices by providers and/or
recipients and make necessary referrals for investigation; prepare written material for
administrative fair hearings; examine patient records to assess quality of care received;
prepare written reports regarding providers’ adherence to requirements of the Medicaid
program; and provide oral testimony on the State’s behalf at hearings, court proceedings, and
Some positions may require additional credentials or a background check to verify your identity.
Notes on ApplyingSubmit resume, preferably in PDF format, by email to firstname.lastname@example.org, with Reference SC/PHD/90605 included in the subject line or by mail to Human Resources Management Group, SC/PHD/90605, Rm 2217, Corning Tower Building, Empire State Plaza, Albany, NY 12237-0012, or by fax to (518) 473-3395. Failure to include the required information may result in your resume not being considered for this position. Resumes will be accepted until October 18, 2021.