Dental Clinical Reviewer
Company: VirtualVocations
Location: Kissimmee
Posted on: February 5, 2025
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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, Tampa , Dental Clinical Reviewer, Healthcare , Kissimmee, Florida
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