How to Become a Dental Claims Consultant in 6 Steps

Must read

Working as a dental claims consultant offers many unique opportunities for working as a dentist and managing claims as a consultant. Dental claims consultants use their extensive knowledge of dentistry and law to help clients file claims and fight fraud. By learning more about becoming a dental claims consultant, you can decide if this career is right for you. In this article, we will discuss what a dental claims consultant is, what they do, what skills they use, and how to become a dental claims consultant.

What is a Dental Claims Consultant?

A dental claims consultant is a professional lawyer who also has experience and experience in dentistry. They handle dental related law for customer and dentist claims as well as for insurance companies. They work with clients and other dentists to file complaints and improve overall dental practice. These professionals may provide advice on marketing, human resources, office management, equipment purchases, or training for specific dental practices. Some dentists looking to open their own independent office may hire dental consultants to help them grow their business.

Dentists may hire consultants to expand their practice, offer new software, or comply with new laws. Dental consultants may operate their own offices independently or work as managers whose responsibilities include recruiting, advertising, and monitoring both patients and practices.

What does a dental claims consultant do?

What does a dental claims consultant do?

Dental claims consultants act as an intermediary between the client, the dentist, and the insurance company to reach an agreement on a claim. For example, a client may file a claim that a dentist crowned a tooth that was not contractually obligated to crown. A dental claims consultant may work with an insurance company to obtain a contract, evaluate the claim, and either approve or deny the claim.

If they are satisfied with the claim, the dentist and the client can proceed to litigation. If they refuse to do so, the dentist may either face contractual liability for breach of contract laws or may lose the claim against the client. While most of the duties of a dental claims consultant may be legal, they may also perform dental work from their original office.

Dental Claims Consultant Skills

Some of the skills that dental claims consultants use in their roles include:

Attention to detail

Because dental claims consultants work as dentists first, attention to detail can help them succeed in both dental work and office management. Dental claims consultants handle claims between clients and fellow dentists and process legal paperwork, claim forms, and x-rays. Some claims disputes require detailed analysis of the client’s x-rays, making attention to detail an important skill in a consultant’s day-to-day work.

Communication skills

Dental claims consultants deal with many types of people in different positions. They may communicate with dentists about false claims or with clients to explain the legal implications of what the claim means. They may train dentists by explaining complex dental concepts or help other staff with scheduling. As prospective business owners, dental claims consultants may also take on management and publicity responsibilities, making written communication skills beneficial to the well being of their business. Because they write damage reports, dental counselors use written communication on an almost daily basis to convey important information.

Knowledge and skill of the dentist

For consultants, knowledge of dentistry is important for educating others and asserting claims. Dental claims counselors understand contract law between clients, dentists, and insurance companies regarding both contract law and dental claim standards. An extensive knowledge of the procedures, including any potential malpractice, can help dental claims counselors make accurate decisions for each party.

Managerial abilities

Because dental claims consultants may be able to run their own dental office, understanding how to run a business can help them succeed in their careers. Knowing how to resolve common employee conflicts, create schedules, and manage payroll can help them keep their business running efficiently. They may have to take responsibility for other dentists as practitioners or train dentists in specialized procedures. The ability to lead and teach confidently are managerial skills that can help dental consultants pursue diverse careers.

Business Knowledge

As business owners, dental claims consultants are financially savvy. They can keep records, organize documents and manage large amounts of important data such as customer profiles. A basic knowledge of business can help dental claims consultants comply with business practice laws and keep an office up and running.

Terms and Conditions for a Dental Claims Consultant

Dental claims consultants work in an office, usually in a dental office. They may work in a private office as a contracted consultant before moving on to freelance work, but they usually gain experience as consultants in a dental office first. As far as claims consultants are concerned, most of their duties are related to investigating and evaluating claims between dentists and clients. Clients and dentists may or may not be from the office they work in, although they receive any claims within the area, depending on the number of claims advisors available nearby.

Requirements assessment work includes office work for both research and remote consultation. Dental claims counselors may meet with clients or dentists to discuss the details of the claim in person. When not working with claims, dental consultants may care for patients like dentists or run an office like a business owner.

Dental Claims Consultant Salary and Job Outlook

Dental claims consultants earn an average of $68,130 per year, according to the U.S. Bureau of Labor Statistics . The BLS predicts that consultant job prospects could decrease by 6% through 2029. While this is a decline, the BLS also predicts that despite a projected decline in employment, an average of 22,100 claims adjuster jobs could open each year for the next decade.

How to Become a Dental Claims Consultant

If you are considering becoming a dental claims consultant, consider some of the following steps:

1. Get a bachelor’s degree

To apply to a dental school, first work towards a bachelor’s degree. While your bachelor’s degree doesn’t have to be related to dentistry, consider taking courses that can help you prepare for law, management, and dental work. Some helpful courses for a dental claims consultant include:

  • Accounting. As a dental claims consultant, accounting principles can help you figure out how to financially stabilize your business. Accounting courses can also give you valuable lessons in organization, accounting, and business strategy.

  • Business Finance: Just like accounting, business finance can help you better understand how to run a dental business. In addition, business finance can also teach you basic economic principles that you can apply to your business wherever you work.

  • Management: Studying the principles of management in university courses can help you further apply leadership qualities in your career.

  • Law: Understanding the basics of dental law is a good way to help you become a consultant. Law courses can also help you learn how to write legal documents.

2. Pass the entrance exam

To enroll in a dental school, take the entrance exam to the dental clinic. This exam assesses your general dental skills. Combined with your GPA, dental schools use this score to determine if you qualify. Maintaining a GPA of 3.2 or higher can help increase your chances of being accepted into a competitive dental program by recruiters.

3. Get a Diploma in Dentistry

When you pass the entrance exam for dentistry, you can earn a Doctor of Dental Surgery degree. While you can earn a DMD, dental claims consultants usually have a DDS, both for understanding medicine and performing and teaching various procedures. In both study programs, you can expect to work in a classroom for a minimum of two years before starting clinical dental office work as a student.

4. Get a license

To practice dentistry, you need to obtain a valid license in your state. Different licenses may allow you to practice different types of practice, including orthodontics, pediatrics, and surgery. Purchasing multiple licenses as a dental claims consultant can both broaden the scope of your practice and prepare you to train others in a variety of techniques in the future. Each license takes two to four years to obtain.

5. Get a specialization

Once you have obtained all the licenses required to practice in your state and areas, consider further specializing with one of your licenses. For example, if you want to specialize in surgery, you can set up an independent dental claims advisory service solely for surgery if you have a deep understanding of the principles of specialization. Work on defining the specialization you want to work in and gain knowledge in that area.

6. Consider Certification

Once you become a knowledgeable dentist, you can begin to acquire other skills that will enable you to work as an insurance consultant. In addition to courses in general accounting, management, and business studies, earning a certificate in business administration can help with the application process. While it is possible to start a business as a dental claims consultant with knowledge in the field of dentistry, earning a Master of Business Accreditation (MBA) or general business certification can help you become a practicing consultant on behalf of your current office.

More articles


Please enter your comment!
Please enter your name here

Latest article