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