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Utilization Management Clinical Processor

Company: VirtualVocations
Location: Arvada
Posted on: November 8, 2024

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, Snowmass , Utilization Management Clinical Processor, Healthcare , Arvada, Colorado

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