Dental Utilization Management Processor

Job Summary

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
• Evaluate service requests and determine the appropriateness of treatments using clinical criteria
• Document approval decisions and maintain productivity standards in accordance with departmental requirements

Required Qualifications

• High School Diploma or equivalent required
• 2+ years of experience as a Dental Assistant or Dental Hygienist required
• Dental Assistant certificate or 2 years of chair side assisting required
• 2 years of experience reviewing dental x-rays and patient charts required
• Proficiency with Microsoft Office and other Windows-based applications