Dental Utilization Management Processor

Job Summary

A company is looking for a Utilization Management Clinical Dental Processor.

Key Responsibilities

• Conduct timely and accurate reviews of medical necessity determinations for treatment requests
• Document approval decisions and maintain compliance with relevant regulations and policies
• Collaborate with providers and members to gather necessary information for thorough reviews

Required Qualifications

• High School Diploma or Equivalent required
• Minimum of 2 years' experience in dental benefit administration or related role
• Dental Assistant or Dental Hygienist certification required
• Experience reviewing dental x-rays, models, and patient charts required
• Proficiency in utilizing Windows-based computer programs and MS Office Suite applications