... Utilization Review Coordinator to coordinate patients' services across the continuum of care by ... Medical, Dental, and Vision Insurance * NPH 401(k) plan with up to 4% Company match * Employee ...
... Utilization Review Coordinator to coordinate patients' services across the continuum of care by ... Medical, Dental, and Vision Insurance * NPH 401(k) plan with up to 4% Company match * Employee ...
Excellent Medical, Dental, Vision and Prescription Drug Plan * 401(K) with company match and ... Shift differentials are paid for evening, night and weekend shifts Position Summary The Utilization ...
Excellent Medical, Dental, Vision and Prescription Drug Plan * 401(K) with company match and ... Shift differentials are paid for evening, night and weekend shifts Position Summary The Utilization ...
... Utilization Review Coordinator to coordinate patients' services across the continuum of care by ... Medical, Dental, and Vision Insurance * NPH 401(k) plan with up to 4% Company match * Employee ...
... Utilization Review Coordinator to coordinate patients' services across the continuum of care by ... Medical, Dental, and Vision Insurance * NPH 401(k) plan with up to 4% Company match * Employee ...
Excellent Medical, Dental, Vision and Prescription Drug Plan * 401(K) with company match and ... Shift differentials are paid for evening, night and weekend shifts Position Summary The Utilization ...
Excellent Medical, Dental, Vision and Prescription Drug Plan * 401(K) with company match and ... Shift differentials are paid for evening, night and weekend shifts Position Summary The Utilization ...
... Utilization Review Coordinator to coordinate patients' services across the continuum of care by ... Medical, Dental, and Vision Insurance * NPH 401(k) plan with up to 4% Company match * Employee ...
... Utilization Review Coordinator to coordinate patients' services across the continuum of care by ... Medical, Dental, and Vision Insurance * NPH 401(k) plan with up to 4% Company match * Employee ...
Excellent Medical, Dental, Vision and Prescription Drug Plan * 401(K) with company match and ... Shift differentials are paid for evening, night and weekend shifts Position Summary The Utilization ...
Excellent Medical, Dental, Vision and Prescription Drug Plan * 401(K) with company match and ... Shift differentials are paid for evening, night and weekend shifts Position Summary The Utilization ...
Responsibilities Benefit Highlights: · Excellent Medical, Dental, Vision and Prescription Drug ... Utilization Review Manager. Position Description: The Utilization Manager is responsible for ...
Responsibilities Benefit Highlights: · Excellent Medical, Dental, Vision and Prescription Drug ... Utilization Review Manager. Position Description: The Utilization Manager is responsible for ...
Responsibilities Benefit Highlights: · Excellent Medical, Dental, Vision and Prescription Drug ... Utilization Review Manager. Position Description: The Utilization Manager is responsible for ...
Responsibilities Benefit Highlights: · Excellent Medical, Dental, Vision and Prescription Drug ... Utilization Review Manager. Position Description: The Utilization Manager is responsible for ...
Responsibilities Benefit Highlights: • Excellent Medical, Dental, Vision and Prescription Drug ... Utilization Review Manager. Position Description: The Utilization Manager is responsible for ...
Responsibilities Benefit Highlights: • Excellent Medical, Dental, Vision and Prescription Drug ... Utilization Review Manager. Position Description: The Utilization Manager is responsible for ...
Utilization Review Medical Director
Troy, MI · On-site +1
$250K - $250K/yr
The Utilization Review Medical Director is responsible for conducting clinical reviews of Durable ... Medical, Vision, and Dental benefits * Paid Time Off (PTO) * Paid Parental Leave * Sick Time * Paid ...
Utilization Review Medical Director
Troy, MI · On-site +1
$250K - $250K/yr
The Utilization Review Medical Director is responsible for conducting clinical reviews of Durable ... Medical, Vision, and Dental benefits * Paid Time Off (PTO) * Paid Parental Leave * Sick Time * Paid ...
Excellent Medical, Dental, Vision and Prescription Drug Plan * 401(K) with company match and ... review current topics within the industry. Having the opportunity to grow, learn, and advance in ...
Excellent Medical, Dental, Vision and Prescription Drug Plan * 401(K) with company match and ... review current topics within the industry. Having the opportunity to grow, learn, and advance in ...
Excellent Medical, Dental, Vision and Prescription Drug Plan * 401(K) with company match and ... review current topics within the industry. Having the opportunity to grow, learn, and advance in ...
Excellent Medical, Dental, Vision and Prescription Drug Plan * 401(K) with company match and ... review current topics within the industry. Having the opportunity to grow, learn, and advance in ...
Excellent Medical, Dental, Vision and Prescription Drug Plan * 401(K) with company match and ... review current topics within the industry. Having the opportunity to grow, learn, and advance in ...
Excellent Medical, Dental, Vision and Prescription Drug Plan * 401(K) with company match and ... review current topics within the industry. Having the opportunity to grow, learn, and advance in ...
Medical, dental, vision, and life insurance 401(k) retirement savings plan with employer match ... The Group Director, Utilization Review will perform the functions necessary to support and advance ...
New
Medical, dental, vision, and life insurance 401(k) retirement savings plan with employer match ... The Group Director, Utilization Review will perform the functions necessary to support and advance ...
New
Medical, dental, vision, and life insurance 401(k) retirement savings plan with employer match ... The Group Director, Utilization Review will perform the functions necessary to support and advance ...
New
Medical, dental, vision, and life insurance 401(k) retirement savings plan with employer match ... The Group Director, Utilization Review will perform the functions necessary to support and advance ...
New
Hours are Monday - Friday from 830am until 5pm with no weekends EDUCATION AND EXPERIENCE: * RHIT ... Previous utilization management or case management experience preferred. CERTIFICATIONS/LICENSURES ...
Hours are Monday - Friday from 830am until 5pm with no weekends EDUCATION AND EXPERIENCE: * RHIT ... Previous utilization management or case management experience preferred. CERTIFICATIONS/LICENSURES ...
Hours are Monday - Friday from 830am until 5pm with no weekends EDUCATION AND EXPERIENCE: * RHIT ... Previous utilization management or case management experience preferred. CERTIFICATIONS/LICENSURES ...
Hours are Monday - Friday from 830am until 5pm with no weekends EDUCATION AND EXPERIENCE: * RHIT ... Previous utilization management or case management experience preferred. CERTIFICATIONS/LICENSURES ...
At Delta Dental of Michigan, Ohio, and Indiana we work to improve oral health through benefit plans ... Utilization Review Accreditation Commission (URAC), Credentialing and Recredentialing (CR ...
At Delta Dental of Michigan, Ohio, and Indiana we work to improve oral health through benefit plans ... Utilization Review Accreditation Commission (URAC), Credentialing and Recredentialing (CR ...
At Delta Dental of Michigan, Ohio, and Indiana we work to improve oral health through benefit plans ... Utilization Review Accreditation Commission (URAC), Credentialing and Recredentialing (CR ...
At Delta Dental of Michigan, Ohio, and Indiana we work to improve oral health through benefit plans ... Utilization Review Accreditation Commission (URAC), Credentialing and Recredentialing (CR ...
At Delta Dental of Michigan, Ohio, and Indiana we work to improve oral health through benefit plans ... Utilization Review Accreditation Commission (URAC), Credentialing and Recredentialing (CR ...
At Delta Dental of Michigan, Ohio, and Indiana we work to improve oral health through benefit plans ... Utilization Review Accreditation Commission (URAC), Credentialing and Recredentialing (CR ...
Weekend Dental Utilization Review information
What are the key skills and qualifications needed to thrive as a Weekend Dental Utilization Review specialist, and why are they important?
To thrive as a Weekend Dental Utilization Review specialist, you need a background in dental hygiene or dentistry, strong analytical skills, and familiarity with insurance guidelines, often supported by a dental degree or RDH certification. Proficiency with utilization review software, electronic health records, and knowledge of dental coding systems like CDT is typically required. Attention to detail, clear written communication, and strong organizational skills help in evaluating claims and collaborating with providers. These skills are essential to ensure accurate, timely claim assessments and uphold standards of care while minimizing unnecessary costs.
What are the most common challenges faced by professionals in a Weekend Dental Utilization Review role?
Professionals in Weekend Dental Utilization Review roles often face the challenge of managing high volumes of case reviews within tight deadlines, as weekend shifts are usually designed to address backlogs or urgent requests. Additionally, working outside of regular business hours can mean limited access to immediate team support or provider clarification. Strong attention to detail and the ability to interpret dental records independently are essential. Effective communication skills are also important, as collaboration with providers and insurance teams may require clear, concise documentation and follow-up.
What is a Weekend Dental Utilization Review job?
A Weekend Dental Utilization Review job involves evaluating dental treatment requests and claims to ensure they meet established guidelines and are medically necessary. Professionals in this role review patient records, treatment plans, and documentation, often working for insurance companies or dental benefits organizations. The primary goal is to approve appropriate care and prevent unnecessary expenses, typically during weekend hours when regular staff may be unavailable. This work requires a background in dentistry or dental hygiene, attention to detail, and knowledge of insurance protocols.
What is the difference between Weekend Dental Utilization Review vs Weekend Dental Claims Processor?
| Aspect | Weekend Dental Utilization Review | Weekend Dental Claims Processor |
|---|---|---|
| Primary Role | Assessing the necessity and appropriateness of dental services for insurance claims | Processing and reviewing dental insurance claims for accuracy and completeness |
| Required Credentials | Dental or healthcare-related certifications, knowledge of insurance policies | Basic insurance processing knowledge, attention to detail |
| Work Environment | Office-based, insurance or healthcare companies, often remote | Office or remote, insurance companies, dental benefit providers |
| Common Usage | Evaluating dental service requests for coverage approval | Handling claims submissions and verifying claim details |
Weekend Dental Utilization Review focuses on evaluating dental service requests for insurance coverage, requiring clinical knowledge and insurance familiarity. In contrast, Weekend Dental Claims Processors handle the administrative aspect of claims, verifying and processing submissions. Both roles are essential in dental insurance operations but differ in their primary functions and required skills.
What are the most commonly searched types of Dental Utilization Review jobs in Michigan? The most popular types of Dental Utilization Review jobs in Michigan are:
What cities in Michigan are hiring for Weekend Dental Utilization Review jobs? Cities in Michigan with the most Weekend Dental Utilization Review job openings:
Full-time
Medical, Dental, Vision, Retirement, PTO
Posted 10 days ago
Job description
About UsHealing Body and Mind.
NeuroPsychiatric Hospitals is a national leader in behavioral healthcare, specializing in patients with acute psychiatric and complex medical needs. Our hospitals use an interdisciplinary, multi-specialty approach that delivers high-quality, patient-centered care when it's needed most.
With locations in Indiana, Michigan, Texas, and Arizona, we're expanding access to our unique model of care across the United States. Join us and be part of a team dedicated to making a lasting difference in the lives of patients and families every day
OverviewKalamazoo Behavioral Health Hospital is looking for a Utilization Review Coordinator to coordinate patients' services across the continuum of care by promoting effective utilization, monitoring health resources and elaborating with multidisciplinary teams.
Benefits of joining NPH
- Competitive pay rates
- Medical, Dental, and Vision Insurance
- NPH 401(k) plan with up to 4% Company match
- Employee Assistance Program (EAP) Programs
- Generous PTO and Time Off Policy
- Special tuition offers through Capella University
- Work/life balance with great professional growth opportunities
- Employee Discounts through LifeMart
- Filing documents as needed.
- Initial Precertification with payors.
- Concurrent Clinical review with payors.
- Document in the electronic system daily in real time.
- Admission audit.
- Ensures that CON's/RON's and CMS certifications are completed by provider.
- Consistently demonstrates professionalism with all internal and external customers as evidenced by positive customer and peer Communicates effectively with all staff and patients as evidenced by the establishment and maintenance of productive working relationships.
- Maintains knowledge of current trends and developments in the field by reading appropriate books; journals and other literature and attending related seminars or conferences.
- Maintains a professional approach with Assures protection and privacy of health information as attained through written, electronic or oral disclosures.
- Cooperates and maintains good rapport with nursing staff, medical staff, and other departments.
- Seeks guidance and remains knowledgeable of, and complies with, all applicable federal and state laws, as well as hospital polices that apply.
- Complies with hospital expectations regarding ethical behavior and standards of conduct.
- Complies with federal and hospital requirements in the areas of protected health information and patient information.
- Reconsiderations, assists with appeals as needed, arrange peer to peer level reviews, and report the outcomes to the VP of Care Management and Team.
- Provides education to nursing staff. ;eadership team, and providers regarding documentation.
- Actively works with the business office regarding resolution of appeals/denials and retrospective reviews.
Education: Bachelor's in Behavioral Health, Social Work, Counseling, Nursing or Psychology required. Master's degree preferred.
Experience: Minimum of 2 years of utilization review experience in a hospital setting required. Minimum of 2 years of case management experience, including discharge planning in a hospital setting required.
Licensure: Certified Case Manager (CCM) or Accredited Case Manager (ACM) preferred. Basic Life Support (BLS) and Handle with Care (HWC) obtained during orientation, if applicable.
Skills: Must have strong knowledge of medications and demonstrate exceptional time management, data entry, and communication skills. Must be detail oriented.#INDEEDLOW
Employment Type: FULL_TIME