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Dental Clinical Reviewer

Company: VirtualVocations
Location: Austin
Posted on: February 4, 2025

Job Description:

A company is looking for a Clinical Reviewer to manage claims and ensure operational efficiency in the dental benefits sector.



Key Responsibilities

Manage claims throughout their lifecycle, ensuring accurate processing of non-auto-adjudicated claims
Review clinical documentation to assess the efficacy of treatment plans
Analyze provider and member inquiries regarding finalized claims and coverage decisions


Required Qualifications

5+ years of experience in insurance back-office functions or clinical roles, preferably in dental insurance
Proficient in dental insurance coding and claims processing
Experience interpreting dental health information from x-rays and clinical documentation
Strong organizational skills to manage multiple claims in a fast-paced environment
Familiarity with utilization management and clinical review processes

Keywords: VirtualVocations, San Antonio , Dental Clinical Reviewer, Healthcare , Austin, Texas

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