FOH Consulting Dentist – PRN
STGi is currently seeking a Dentist to provide medical consultation and case review evaluations on Worker's Compensation cases. The position is open to candidates nationwide and is fully remote.
Job Specific Duties and Responsibilities: Provide dental consultation and case review evaluations on Workers’ Compensation cases, primarily for the Department of Labor (DOL) on Federal Employee Compensation Act cases.
The Joint Commission – Quality and Safety
• Completes training on DFEC policy, procedures, and regulations prior to performing case reviews.
• Performs dental consultation in accordance with FOH’s policy and standard operating procedures.
Service Operations
• Supports the dental and consultative needs for the Department of Labor (DOL) and other federal agency (when requested) workers’ compensation programs.
• Evaluates workers’ compensation case files, interprets dental reports, evaluates dental evidence and test results, translates technical dental language, and provides guidance or instruction to customer agencies regarding general dental issues that pertain to workers’ compensation cases.
• Performs DOL FECA case reviews in accordance with DOL FECA regulations. The type of case reviews include:
o Dental Review – Routine: This category will cover review for routine dental authorization or opinion on issues including, but not limited to, the need for extended dental treatment, consequential condition causal relationship, etc. Provides a written opinion for dental review cases within 10 business days of receipt.
o Dental Review – Complex: This category will cover review for dental authorization or opinion on complex issues including, but not limited to, complex dental conditions (i.e., cases that require the replacement of many teeth, malocclusion correction, periodontal treatment, etc.). Provides written dental opinion response for this case type within 20 business days of receipt.
o Impairment Rating (Routine and Complex): Provides dental consultation on impairment ratings for cases involving dental issues. Impairment rating evaluations are conducted in accordance with the AMA Guides to the Evaluation of Permanent Impairment (6th edition). Provides a written opinion for impairment rating case reviews within 10 or 20 business days of receipt for simple and complex cases, respectively.
o Death Claim Review: Evaluate dental information in death claims for causal relationship. Provides a written opinion for this case type within 10 business days of receipt.
o Expedited Review – Performs reviews on catastrophic dental injury cases or other instances in which an expedited response is required to approve care. Provide written dental opinions for this case type within 3 business days of receipt.
• Demonstrates a strong level of technical expertise in performing dental consultation for workers’ compensation cases and an ability to work and communicate orally and in writing. Renders dental opinions with a reasonable degree of medical certainty and provides clear written rationale for these dental opinions.
• Possesses a strong technical knowledge regarding federal safety and health and workers’ compensation regulations.
• Demonstrates a high level of professional conduct.
• Provides expert dental advice and consultation to FOH and its federal customer agencies on worker’s compensation issues.
Clinical
• May be required to conduct hands-on examinations (if so privileged by FOH), render a professional opinion as it relates to work clearances or recommendations consistent with the examination findings and established physical qualifications.
Procurement
• Submit monthly billing in the specified format and by specified deadlines.
Staffing and Reporting Relationships
• Receives program direction from the FOH Medical Director.
Technology
• Complies with DFEC program requirements regarding access to and use of DOL databases or applications that contain confidential dental, medical and personal information.
Required Skills
Minimum Requirements/Knowledge/Skills
• Active dental practice with a minimum of 240 hours of direct patient care per year to participate as a dental provider under the Federal Employees' Compensation Act.
• Must possess expert understanding of Federal safety and health regulations, and experience reviewing worker’s compensation cases. A broad knowledge of requirements of federal workers compensation is desired.
• Demonstrated experience in dealing with various size organizations representing widely divergent backgrounds, points of view, and levels of authority (i.e., labor union and management issues relating to worker’s compensation).
• Maintain current BLS certification, if conducting direct patient evaluations.
• Basic computer skill proficiency
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Job Specific Duties and Responsibilities: Provide dental consultation and case review evaluations on Workers’ Compensation cases, primarily for the Department of Labor (DOL) on Federal Employee Compensation Act cases.
The Joint Commission – Quality and Safety
• Completes training on DFEC policy, procedures, and regulations prior to performing case reviews.
• Performs dental consultation in accordance with FOH’s policy and standard operating procedures.
Service Operations
• Supports the dental and consultative needs for the Department of Labor (DOL) and other federal agency (when requested) workers’ compensation programs.
• Evaluates workers’ compensation case files, interprets dental reports, evaluates dental evidence and test results, translates technical dental language, and provides guidance or instruction to customer agencies regarding general dental issues that pertain to workers’ compensation cases.
• Performs DOL FECA case reviews in accordance with DOL FECA regulations. The type of case reviews include:
o Dental Review – Routine: This category will cover review for routine dental authorization or opinion on issues including, but not limited to, the need for extended dental treatment, consequential condition causal relationship, etc. Provides a written opinion for dental review cases within 10 business days of receipt.
o Dental Review – Complex: This category will cover review for dental authorization or opinion on complex issues including, but not limited to, complex dental conditions (i.e., cases that require the replacement of many teeth, malocclusion correction, periodontal treatment, etc.). Provides written dental opinion response for this case type within 20 business days of receipt.
o Impairment Rating (Routine and Complex): Provides dental consultation on impairment ratings for cases involving dental issues. Impairment rating evaluations are conducted in accordance with the AMA Guides to the Evaluation of Permanent Impairment (6th edition). Provides a written opinion for impairment rating case reviews within 10 or 20 business days of receipt for simple and complex cases, respectively.
o Death Claim Review: Evaluate dental information in death claims for causal relationship. Provides a written opinion for this case type within 10 business days of receipt.
o Expedited Review – Performs reviews on catastrophic dental injury cases or other instances in which an expedited response is required to approve care. Provide written dental opinions for this case type within 3 business days of receipt.
• Demonstrates a strong level of technical expertise in performing dental consultation for workers’ compensation cases and an ability to work and communicate orally and in writing. Renders dental opinions with a reasonable degree of medical certainty and provides clear written rationale for these dental opinions.
• Possesses a strong technical knowledge regarding federal safety and health and workers’ compensation regulations.
• Demonstrates a high level of professional conduct.
• Provides expert dental advice and consultation to FOH and its federal customer agencies on worker’s compensation issues.
Clinical
• May be required to conduct hands-on examinations (if so privileged by FOH), render a professional opinion as it relates to work clearances or recommendations consistent with the examination findings and established physical qualifications.
Procurement
• Submit monthly billing in the specified format and by specified deadlines.
Staffing and Reporting Relationships
• Receives program direction from the FOH Medical Director.
Technology
• Complies with DFEC program requirements regarding access to and use of DOL databases or applications that contain confidential dental, medical and personal information.
Required Skills
Minimum Requirements/Knowledge/Skills
• Active dental practice with a minimum of 240 hours of direct patient care per year to participate as a dental provider under the Federal Employees' Compensation Act.
• Must possess expert understanding of Federal safety and health regulations, and experience reviewing worker’s compensation cases. A broad knowledge of requirements of federal workers compensation is desired.
• Demonstrated experience in dealing with various size organizations representing widely divergent backgrounds, points of view, and levels of authority (i.e., labor union and management issues relating to worker’s compensation).
• Maintain current BLS certification, if conducting direct patient evaluations.
• Basic computer skill proficiency
Apply tot his job
Apply To this Job