Utilization Management Representative
$41,600 - $41,600/Yr
TEKsystems - Richmond, KY
posted 29 days ago
Full-time - Entry Level
Remote - Richmond, KY
10,001+ employees
Professional, Scientific, and Technical Services
About the position
The Utilization Management Representative at TEKsystems is responsible for reviewing dental prior authorizations and referrals, ensuring that member histories are accurate and that all necessary documentation, such as x-rays, is included with claims. This role involves working through the system to finalize cases as needed, contributing to the overall efficiency of dental insurance processes.
Responsibilities
- Review dental prior authorizations and referrals.
- Ensure member history is accurate and free of conflicting information.
- Verify that proper attachments (e.g., x-rays) are included with claims.
- Work through the system to finalize cases as needed.
Requirements
- 2+ years of dental insurance experience
- Experience in utilization management
- Knowledge of prior authorization and referrals
- Front office dental experience
- Experience in treatment coordination
Benefits
- Medical, dental & vision insurance
- Critical Illness, Accident, and Hospital insurance
- 401(k) Retirement Plan with pre-tax and Roth post-tax contributions
- Voluntary Life & AD&D insurance for employees and dependents
- Short and long-term disability insurance
- Health Spending Account (HSA)
- Transportation benefits
- Employee Assistance Program
- Paid Time Off (PTO), Vacation or Sick Leave
