Market leading healthcare organization looking for Clinical Review Support Specialists to in a remote role! Great opportunity, please call us today! Seeking Dental Assistant with Ortho experience. Preferably located in Iowa or the West Coast. JOB SUMMARY:
The Clinical Review Specialist I provides timely and accurate review and authorization of dental services based on eligibility and contract requirements. PRIMARY JOB RESPONSIBILITIES: Successful completion of the Clinical Review Specialist training program Read, interpret and analyze x-rays and requests for major dental services based on medical necessity, client coverage, provider participation and member eligibility Resolve claim and prior authorization that require UM Review Consistently meet productivity requirements Maintain audit score of 95% or greater Pass the IRR quarterly Communicate and work effectively with co-workers and Leads to coordinate workload to ensure all work is completed daily Knowledge of reference materials and documentation that contain market intel Respond to follow-bolthires Provide customer service via the telephone to providers regarding clinical issues Requirements: High School Diploma or equivalent 1 year dental assistance experience Ability to read and interpret x-rays, dental models, photos, and/or patient charts Preferred: Previous Dental Insurance Experience a plus Good interpersonal skills Ability to work independently Excellent communication skills Efficient PC skills (Word, Excel, Outlook) Ability to prioritize and organize multiple tasks Ability to remain organized with multiple interruptions Knowledge of telephone systems Ability to work in excess of 40 hours in a week Required to attend additional training as required/deemed necessary
Experience: Dental assistant: 1 year (Required) Ortho experience: 1 year (Required) Interpreting x-rays, dental models, photos, patient charts: 1 year (Required) Dental insurance: 1 year (Preferred) Work Location:
Remote Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.
At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact [email protected]. Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).
This posting is open for thirty (30) days. It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability. Qualified applicants in San Francisco with criminal histories will be considered for employment in accordance with the San Francisco Fair Chance Ordinance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.
We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance. Apply tot his job