Dental Clinical Reviewer - Oklahoma City Oklahoma

Company: VirtualVocations
Location: Oklahoma City, Oklahoma
Posted On: 02/06/2025

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 More...

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