Advanced working expertise in dental benefit administration, CDT coding, dental claims adjudication, coordination of benefits, dental benefit structures, and common billing practices, with the demonstrated ability to independently evaluate coding accuracy, benefit application, claim adjudication logic, and payment appropriateness in complex dental claims and appeal scenarios. Operating as a senior individual contributor within a federally regulated dental benefits program, the Specialist independently determines documentation sufficiency, identifies when additional clinical review or policy interpretation is required, defines the scope of directed claim reviews, and prepares defensible appeal and audit findings without routine review.