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Acentra Health · 23 hours ago

Dental Reviewer-PRN

United States

Part-time

Remote

Senior Level

5+ years exp

Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. They are looking for a Dental Reviewer to assess patient records to verify that the provided treatment adheres to the plan guidelines and is appropriate for the condition.

Health Care

Responsibilities

Review patient charts, x-rays, and other related records to ensure that the treatment provided is in line with the guidelines of the plan

Check preauthorization paperwork to ensure that the intended treatment meets the criteria of the dental plan

Maintain accurate and detailed records of the work performed in databases

Communicate with provider offices to obtain additional information as necessary

Respond promptly to inquiries from internal and external customers

Enter new authorization determinations, guidelines, and reasons for denial into company systems

Stay current on knowledge and understanding of dental plans and coverage

Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules

Qualification

Licensed Dental HygienistCurrent X-ray licenseClinical dental experienceDental proceduresMicrosoft OfficeEffective communicationOrganizational skillsInterpersonal skillsProblem-solving skillsTeamwork ability