Dental Assistant

Overview

Market leading healthcare organization looking for Clinical Review Support Specialists to join our team in a remote role. Open to Dental Assistants with experience reviewing and interpreting x-rays, models, and requests for services. Location preference:
Iowa and the West Coast.

The Clinical Review Specialist I provides timely and accurate review and authorization of dental services based on eligibility and contract requirements.

• 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 claims 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-ups
• Provide customer service via phone to providers regarding clinical issues

• High School Diploma or equivalent
• 1 year dental assistant experience
• Ability to read and interpret x-rays, dental models, photos, and/or patient charts
• Preferred:
  Previous Dental Insurance Experience
• 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

• Dental Assistant: 1 year (Required)
• Interpreting x-rays, dental models, photos, patient charts: 1 year (Required)
• Dental insurance: 1 year (Preferred)

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. If you require a reasonable accommodation to make your application or interview experience a great one, please contact

Pay offered to a successful candidate will be based on several factors including education, work experience, work location, specific job duties, certifications, etc. Randstad offers a comprehensive benefits package, including medical, prescription, dental, vision, AD&D, and life insurance, short-term disability, and a 401K plan (benefits based on eligibility).

This posting is open for thirty (30) days.

Fair chance and employment notices:
It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. Qualified applicants in San Francisco, Los Angeles, and other applicable locales will be considered in accordance with local laws (San Francisco Fair Chance Ordinance, Los Angeles County Fair Chance Ordinance, California Fair Chance Act, and City of Los Angeles Fair Chance Initiative for Hiring).

We will consider all qualified applicants, including those with criminal histories, in a manner consistent with applicable state and local laws.