Position requires knowledge of the principles and practices of dentistry; knowledge of dental terminology and procedure codes; the ability to render independent clinical opinions regarding dental conditions, procedures, and treatment; knowledge of dental terminology and procedure codes; the ability to review and interpret radiographs and other clinical documentation; the ability to review and resolve complex clinical and benefit related issues; strong written and verbal communication skills; the ability to analyze and resolve highly complex problems; strong interpersonal skills; and the ability to use independent judgment. Provides advanced clinical and operational guidance, coordinates workload, training, audit consistency, new business readiness, clinical system testing, procedural documentation, and cross-functional issue resolution, and performs complex clinical determinations as needed to support prior authorizations, reconsiderations, appeals, grievances, quality-of-care reviews, peer-to-peer reviews, and state fair hearings.