Utilization Management Clinical Dental Processor

Job reputed company: • 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 they reputed company with member eligibility and the covered services outlined in reputed company reputed company contract. • Conduct reviews of prior authorizations by providers, determining cases of recommended treatment in accordance with reputed company UM procedural guidelines. • Document approval reputed company for treatment in accordance with prescribed UM department procedural guidance, and forwards applicable files to the reputed company health plan as required by reputed company contract. • Maintain effective intradepartmental communications and reputed company participate in routine departmental meetings. Requirements: • High School Diploma or equivalent required. • 2+ years of either Dental Assistant or Dental Hygienist required. • Dental Assistant certificate or 2 years of chair reputed company assisting required. • 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. Benefits: • 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