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Commission Dental Utilization Review Jobs (NOW HIRING)

Discovery Institute

Utilization Review

Marlboro, NJ · On-site

Position Summary The Utilization Review (UR) Specialist is responsible for obtaining and ... Ensure compliance with Joint Commission, state, federal, and payer regulations. * Maintain ...

Tuba City Regional

Utilization Review

Tuba City, AZ · On-site

Utilization Review Nurse City/State: Tuba City, Arizona Shift: Monday - Friday from 8am - 5pm ... Ensure compliance with CMS and Joint Commission requirements. * Contribute to reporting and quality ...

Fusion HCR

Utilization Review Nurse

Las Vegas, NV · On-site

Strong knowledge of Joint Commission and CMS guidelines Why Apply * Competitive pay * Stable, high-demand role * Collaborative healthcare environment Apply Now If you have strong Utilization Review ...

Banyan

Utilization Review Specialist

Pompano Beach, FL · On-site

$50K - $65K/yr

Nationally recognized organization - Joint Commission-accredited, with 18 locations and telehealth ... Comprehensive benefits including medical, dental, and vision insurance; whole and term life ...

Prime Time Healthcare

Utilization Review

Baltimore, MD · On-site

Now Hiring: RN Utilization Review - Baltimore, MD Are you a passionate RN professional looking for ... Medical, vision & dental insurance * 401(k) matching program * Flexible schedules * Travel ...

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Commission Dental Utilization Review information

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How much do commission dental utilization review jobs pay per hour?

As of Aug 17, 2026, the average hourly pay for commission dental utilization review in the United States is $42.28, according to ZipRecruiter salary data. Most workers in this role earn between $33.41 and $48.56 per hour, depending on experience, location, and employer.

What is the difference between Commission Dental Utilization Review vs Dental Claims Examiner?

AspectCommission Dental Utilization ReviewDental Claims Examiner
CertificationsDental or healthcare-related certifications, possibly including utilization review credentialsDental claims processing certifications or insurance-related credentials
Work EnvironmentInsurance companies, third-party review organizations, healthcare providersInsurance companies, dental insurance providers, claims processing departments
Primary ResponsibilitiesReviewing dental treatment plans for necessity and appropriateness, ensuring compliance with policiesProcessing and adjudicating dental insurance claims, verifying coverage and payments

Commission Dental Utilization Review focuses on evaluating the necessity of dental treatments, while Dental Claims Examiners handle the processing and approval of insurance claims. Both roles require knowledge of dental insurance policies, but their core functions differ in review versus claims processing.

What cities are hiring for Commission Dental Utilization Review jobs?

Cities with the most Commission Dental Utilization Review job openings:

What are the most commonly searched types of Dental Utilization Review jobs?

The most popular types of Dental Utilization Review jobs are:

What states have the most Commission Dental Utilization Review jobs?

States with the most job openings for Commission Dental Utilization Review jobs include:

Commission Dental Utilization Review jobs near you

Utilization Review

Discovery Institute NJ

Marlboro, NJ • On-site

Other

Posted 24 days ago

Job description

Position Summary
The Utilization Review (UR) Specialist is responsible for obtaining and maintaining insurance authorizations for clients receiving substance use disorder treatment services. This position works closely with clinical staff, admissions, and insurance companies to ensure medical necessity documentation is accurate, authorizations are obtained timely, and reimbursement is maximized while maintaining compliance with payer requirements, Medicaid regulations, and accreditation standards.
Essential Duties and Responsibilities

  • Obtain initial and concurrent insurance authorizations for all levels of care.
  • Review clinical documentation to ensure it supports medical necessity.
  • Submit clinical information to insurance companies within required timeframes.
  • Monitor authorization expiration dates and request extensions before expiration.
  • Communicate authorization decisions and payer requirements to clinical staff.
  • Track approved days and notify leadership of denials or reductions in care.
  • Prepare and submit appeals for denied services when appropriate.
  • Maintain accurate authorization records in the electronic health record (EHR).
  • Work collaboratively with Admissions, Clinical, Nursing, and Billing departments.
  • Verify insurance benefits and coverage when necessary.
  • Monitor payer portals for authorization updates.
  • Assist with Medicaid and managed care authorization processes.
  • Participate in utilization review meetings and case conferences.
  • Generate reports on authorization status, denials, appeals, and payer trends.
  • Ensure compliance with Joint Commission, state, federal, and payer regulations.
  • Maintain confidentiality in accordance with HIPAA regulations.
  • Perform other duties as assigned.
Qualifications
  • High school diploma required; Associate's or Bachelor's degree preferred.
  • Minimum of two years of utilization review, case management, medical billing, or behavioral healthcare experience preferred.
  • Experience in substance use disorder or behavioral health treatment strongly preferred.
  • Knowledge of ASAM Criteria preferred.
  • Familiarity with Medicaid, commercial insurance, and managed care plans.
  • Strong organizational and time management skills.
  • Excellent verbal and written communication skills.
  • Ability to prioritize multiple cases in a fast-paced environment.
  • Proficient in Microsoft Office and electronic health record systems.
Knowledge, Skills, and Abilities
  • Understanding of insurance authorization processes.
  • Knowledge of medical necessity criteria and documentation standards.
  • Strong analytical and critical thinking skills.
  • Excellent customer service and professional communication.
  • Ability to work independently while collaborating with interdisciplinary teams.
  • Attention to detail and accuracy.
  • Ability to maintain confidentiality.
Performance Expectations
  • Maintain timely insurance authorizations with minimal lapses.
  • Reduce avoidable authorization denials.
  • Ensure documentation meets payer standards.
  • Maintain accurate records and reporting.
  • Demonstrate professionalism, teamwork, and excellent customer service.
  • Comply with all organizational policies, HIPAA, Joint Commission standards, and applicable federal and New Jersey regulations.

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