Dental Healthcare Analyst

This is a fully remote position, open to applicants in Maryland.

📋 Description

• Assist in the daily management of appeals within the Par Provider Dental Appeals department.

• Draft determination letters for appeals.

• Prepare requests related to dental services.

• Update relevant systems as needed.

• Generate reports as required.

• Collaborate with clinical support personnel, including Medical Directors, Nurses, and Providers.

• Facilitate the movement of cases within the MedHok system.

• Oversee the resolution of complaints and appeal situations related to dental products.

• Coordinate feedback from various business units.

• Ensure prompt and provider-centered responses to complaints and appeals.

• Detect trends and emerging issues.

• Report findings and propose solutions.

⛳️ Requirements

• Understands current standards, practices, and procedures in dental care.

• Holds a high level of technical expertise and skills in radiograph interpretation.

• If certified or licensed, fulfills necessary continuing education obligations.

• Completed vocational schooling or college-level education beyond high school.

• CDA, RDA, or RDH credential with a minimum of five years of clinical experience.

• Capable of adhering to turnaround times and regulatory requirements.

• Proficient in using the MedHok system.

• Able to coordinate responses among various business units.

🏝️ Benefits

• CVS Health bonus, commission, or short-term incentive program in addition to base salary.

• Medical insurance coverage.

• Dental insurance coverage.

• Vision insurance coverage.

• Paid time off.

• Options for retirement savings.

• Wellness initiatives.

• Additional resources supporting physical, emotional, and financial health, based on eligibility.