Utilization Management Clinical Processor
Company: VirtualVocations
Location: Toms River
Posted on: November 8, 2024
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Job Description:
A company is looking for a Utilization Management Clinical
Processor - Dental to review medical necessity determinations for
dental services.
Key Responsibilities:
Conduct reviews of prior authorizations by providers and determine
treatment recommendations
Document approval decisions for treatment and forward applicable
files to client health plans
Maintain productivity levels in accordance with departmental
requirements and participate in routine meetings
Required Qualifications:
High School Diploma or Equivalent required
Minimum of 2 years' experience in dental benefit administration or
a related role
Dental Assistant certificate or 2 years of chairside assisting
required
1-2 years of experience reviewing dental x-rays, models, and
patient charts required
1-3 years of experience working with highly confidential
information, including PII and HIPAA compliance required
Keywords: VirtualVocations, Westport , Utilization Management Clinical Processor, Healthcare , Toms River, Connecticut
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