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.

• Maintain and update relevant systems.

• Generate necessary reports as required.

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

• Facilitate the movement of cases within the MedHok system.

• Execute tasks in accordance with established turnaround times and regulatory guidelines.

• Oversee complaint and appeal situations concerning dental products until resolution.

• Coordinate inputs from various business units when necessary.

• Ensure prompt, provider-centric replies to complaints and appeals.

• Recognize trends and emerging challenges.

• Document findings and propose potential 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, adheres to all continuing education obligations.

• Possesses vocational or college-level education beyond high school.

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

• Capable of utilizing available resources effectively.

• Demonstrates strong organizational and time-management abilities.

• Capable of thoroughly researching issues and clearly reporting findings, offering options for resolution.

🏝️ Benefits

• Medical coverage.

• Dental coverage.

• Vision coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

• A comprehensive benefits package that promotes physical, emotional, and financial well-being.

• CVS Health bonus, commission, or short-term incentive program.