[Hiring] Clinical Review Dentist @UnitedHealth Group

Role Description

The Clinical Review Dentist is a production role that supports the dental director on claims review. Strong knowledge of dental procedures, terminology and related dental codes along with strong computer and communication skills are crucial to this role.

You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.

• Review of claims and supporting clinical data to provide accurate documentation for the dental director
• Accurate interpretation of radiographs, intra-oral photographs and clinical narratives
• Maintain organization and department defined standard of performance to meet metrics
• Communication with provider offices in accordance with compliance regulations to discuss adverse clinical determinations and to request missing information
• Independently manage individual queue assignments and workflow to meet deadlines, business needs and department and individual metrics
• Acts as a liaison between our dental directors and provider offices to maintain provider/member satisfaction
• Perform individual case review for appeals and grievances related to adverse determinations for dental services
• Participate in peer-to-peer calls with dental providers

The work hours for this position will be from 10 am-7 pm CST and will include 8 hours of coverage every 4th Saturday/Sunday. Working during the weekend will give you a day off during the week.

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Qualifications

• Dental degree from an Accredited Dental School
• Active dental license
• 7+ years of experience in clinical dentistry
• 3+ years dental benefit plan experience with specific exposure to claim review and utilization management or comparable experience
• Ability to pass a credentialing review for practice experience
• Computer proficiency
• Excellent business analytical and writing skills

Requirements

• Experience with Dental Compliance related to Federal Regulations
• All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution (all benefits are subject to eligibility requirements)
• Salary range from $112,700 to $193,200 annually based on full-time employment

Application Deadline

This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.