Dental Utilization Management Processor

A company is looking for a Utilization Management Clinical Processor.

Key Responsibilities

Review dental x-rays and documentation to assess medical necessity for prior authorizations

Conduct initial reviews of medical necessity cases, ensuring compliance with member eligibility and client contracts

Document approval decisions and maintain productivity standards in accordance with departmental requirements

Required Qualifications

High School Diploma / GED

Dental Assistant or Dental Hygienist required

1-2 years of experience reviewing dental x-rays and patient charts

Proficiency with Microsoft Office and other Windows-based applications

Access to reliable internet connection and an appropriate workspace for remote work