9 дней назад
Dental Claims Reviewer (AI)
Вакансия из Hirify Global, списка международных tech-компанийДля мэтча и отклика нужен Plus
Мэтч & Сопровод
Для мэтча с этой вакансией нужен Plus
Описание вакансии
Текст:
TL;DR
Dental Claims Reviewer (AI): Reviewing dental predeterminations, insurance claims, and appeals using clinical expertise and Overjet’s dental AI technology with an accent on medical necessity, member plan benefits, and dental documentation. Focus on evaluating radiographs, communicating decisions to dentists and plan members, and improving review accuracy through training and calibration.
Location: Remote within the United States
Type: Part-time or full-time, 1099 contractor; 30+ hours per week.
Company
develops dental AI technology and provides dental claims review services for insurers through a nationwide network of dental consultants.
What you will do
- Review radiographs and supporting documentation to authorize or deny predeterminations and dental claims.
- Assess medical necessity and eligibility in accordance with member plan benefits, using ’s dental AI technology to support decisions.
- Evaluate appeals, request additional information, revise claim decisions, and make further recommendations.
- Communicate claim review outcomes to participating dentists and plan members.
- Participate in training and calibration sessions and provide feedback to improve review productivity and accuracy.
Requirements
- D.D.S. or D.M.D. from an accredited dental school.
- Minimum of 5 years of clinical experience.
- Active, unrestricted dental license.
- Proficiency with CDT codes and dental procedures.
- Strong computer skills and comfort with remote platforms such as Zoom.
- Excellent written and verbal communication skills.
Nice to have
- 2+ years of prior claims review experience.
Culture & Benefits
- Remote work with a 1099 contractor arrangement.
- Work 30 or more hours per week on a part-time or full-time schedule.
- Participate in training and calibration sessions focused on review quality and consistency.
- Work with dental AI technology supporting clinical claims decisions.
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