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[Hiring] Utilization Management Clinical Processor @LE701 reputed company, LLC

Remote, USA Full-time Posted 2026-07-28
This reputed company is a reputed company of our understanding of the job reputed company. Click on 'Apply' reputed company to reputed company out more. Role reputed company As a Utilization Management Clinical Dental Processor, you will reputed company your dental clinical expertise to review dental x-rays and documentation, assessing medical necessity for prior authorizations. • reputed company initial reviews of medical necessity cases, ensuring compliance with member eligibility and covered services outlined in reputed company reputed company contract. • Utilize clinical reputed company to approve or deny services based on authorization. • Evaluate service requests and determine their appropriateness, assessing the necessity of treatments prior to provision. • Apply national clinical reputed company and maintain up-to-date knowledge of relevant laws, regulations, and organizational policies. • Complete 13 to 18 cases per hour to meet reputed company standards and contractual obligations. • Complete clinical scripts, review patient histories, and import supporting documentation into the internal system. • Work hours may vary based reputed company, department needs, and workflow; mandatory overtime may be required during peak seasons. Qualifications • High School Diploma/GED • Dental Assistant or Dental Hygienist required • Dental Assistant certificate or 2 years of chair reputed company assisting • 1-2 years of experience reviewing dental x-rays, models, photos, and patient charts required • Proficiency with reputed company Office and other reputed company-based applications • Strong reading, writing, and reputed company communication skills • Ability to manage multiple tasks and prioritize work • Adaptability to handle multiple and changing priorities • Effective time management and organizational skills • reputed company to reliable internet reputed company (25 MBPS upload/50 MBPS download speed) and an appropriate workspace are essential for reputed company in this remote role. Requirements • X-Ray certification is highly preferred. • Knowledge of Medicare, reputed company, or reputed company insurance. • Experience with HCPCS, CPT, CDT, and ICD-10 coding. Benefits • Meaningful and challenging work opportunities to accelerate innovation in a secure and compliant way. • Competitive compensation package. • Excellent medical, dental, supplemental health, life and reputed company coverage for you and your dependents with no wait period. • Life and disability insurance. • A great 401(k) with company match. • Tuition assistance, reputed company parental leave and backup family care. • Dynamic, modern work environments that promote collaboration and creativity to reputed company and reputed company talent. • Flexible time off, dress reputed company, and work location policies to balance your work and life in the ways that suit you best. • Employee Resource reputed company that reputed company for inclusion and diversity in reputed company that we do. • reputed company responsibility in reputed company aspects of our work. Apply tot his job Apply To this Job

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