REMOTE Dental Assistant - Clinical Review Support Specialist

Remote Full-time
Market leading healthcare organization looking for a Dental Assistant to join our team in a remote/100% work from home role! Great opportunity, please call us today!

JOB SUMMARY:
The Dental Assistant will work as a Clinical Review Specialist providing timely and accurate review and authorization of dental services based on eligibility and contract requirements.

PRIMARY JOB RESPONSIBILITIES:
Ā• Successful completion of the Clinical Review Specialist training program
Ā• Read, interpret and analyze x-rays and requests for major dental services based on medical necessity, client coverage, provider participation and member eligibility
Ā• Resolve claim and prior authorization that require UM Review
Ā• Consistently meet productivity requirements
Ā• Maintain audit score of 95% or greater
Ā• Pass the IRR quarterly
Ā• Communicate and work effectively with co-workers and Leads to coordinate workload to ensure all work is completed daily
Ā• Knowledge of reference materials and documentation that contain market intel
Ā• Respond to follow-ups
Ā• Provide customer service via the telephone to providers regarding clinical issues

Requirements
Ā• High School Diploma or equivalent
Ā• 1 year dental assisting experience - REQUIRED
Ā• Ability to read and interpret x-rays, dental models, photos, and/or patient charts
Ā• Preferred: Previous Dental Insurance Experience a plus
Ā• Good interpersonal skills
Ā• Ability to work independently
Ā• Excellent communication skills
Ā• Efficient PC skills (Word, Excel, Outlook)
Ā• Ability to prioritize and organize multiple tasks
Ā• Ability to remain organized with multiple interruptions
Ā• Knowledge of telephone systems
Ā• Ability to work in excess of 40 hours in a week
Ā• Required to attend additional training as required/deemed necessary

Job Types: Full-time, Contract

Pay: $23.00 - $25.00 per hour

Benefits:
Ā• 401(k)
Ā• Dental insurance
Ā• Health insurance
Ā• Vision insurance

Schedule:
Ā• 8 hour shift
Ā• Day shift
Ā• Monday to Friday

Education:
Ā• High school or equivalent (Required)

Experience:
Ā• Dental assisting: 1 year (Required)
Ā• dental insurance: 1 year (Preferred)
Ā• X-Ray: 1 year (Preferred)

Work Location: Remote

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