Remote Staff Dentist — UM & Claims Review Leader
Paycom - ATS
- Remote job
Liberty Dental Plan is seeking an experienced Staff Dentist to join our Clinical Operations team in a fully remote role. You will support coverage determinations, provider engagement, and quality initiatives while ensuring high-quality dental care across Medicaid, Medicare Advantage, Commercial, and Marketplace lines. The ideal candidate has at least six years of experience, an active U.S. dental license, and proven success reviewing claims, prior authorizations, and treatment plans with #J-18808-Ljbffr Paycom - ATS
- ...Senior Staff Dentist, Utilization Management (Remote) NY Fully Remote New York - NY Help Shape the Future... ...for Utilization Management (UM) and Utilization Review (UR) programs. This role ensures... ...adjudication of dental claims and prospective service requests...Remote jobClaimsWork at officeImmediate startFlexible hours
$150k - $165k
...seeking an experienced Staff Dentist to join our Clinical... ...scale. In this fully remote role, you will leverage... ...position supports dental claims review operations for... ...Utilization Management (UM) and Utilization Review... ...experienced clinical leaders and contribute to evidence...Remote workClaimsWork at officeImmediate startRelocationVisa sponsorshipFlexible hours- Vytwo seeks a Physician ED Claims Reviewer for a 12-month remote assignment. The clinician will conduct clinical review of claims and UM authorization requests to determine clinical necessity, leveraging CPT/HCPCS coding and managed care expertise. Ideal candidates hold...Remote jobClaims
- MaziCTools is hiring a Staff Counsel for Insurance Defense to oversee case strategy, manage... ...defense efforts nationwide. This fully remote role requires strong trial experience and... .... You will lead and train attorneys and claims staff, handle complex defenses, and communicate...Remote jobClaims
- ...Summary The Staff Dentist will function as a general dentist, practicing the full range... ...obtain a copy of the ECFMG certificate, if claimed by the applicant. ~AND~ Completed, or... ...more about federal benefits. Review our benefits Eligibility for benefits...Remote workClaimsFull timePart timeSeasonal workLocal areaImmediate startRelocation packageMonday to Friday
$65k - $75k
...North America, seeks a new REVIEW TEAM MANAGER! FLEXIBLE POSITION - REMOTE OR HYBRID ROLE... ...serve as a member of the Claims Force team (formerly known... ...Manager is to lead a team of staff estimate reviewers in... ...Claims Force and other leaders in the onboarding process...Remote workClaimsTemporary workWork at officeLocal areaWork from homeFlexible hours- ...Role: Physician ED Claims Reviewer Duration: 12 months Required skills: Physician with an active... ...conduct clinical review of claims and UM authorization requests for clinical... ...Ability to work independently in a fast paced environment. This is a remote position....Remote workClaims
- ...experienced DRG Clinical Physician Reviewer to join our growing clinical review team. This is a fully remote opportunity for a physician... ...review experience (UM, DRG Validation, or clinical documentation... ...with DRG Validation, CDI, or claims review strongly preferred ~...Remote workClaims
$60.1k - $85.8k
...Lead Associate, Itemized Bill Review Quality Auditor to perform reviews... ...medical records, healthcare claims, itemized medical bill, and UB... ...by clinical and coding review staff, validates audit findings, and... ...with Gainwell, an industry leader. You’ll be joining a company where...Remote workClaimsFull timeWork from homeFlexible hours$78k - $88k
...Coding Auditor, Itemized Bill Review and Appeals who is responsible... ...to perform reviews of multiple claim types to provide a flexible... ...expect in this role Fully remote (U.S.-based) Up to 25% travel... ...career with Gainwell, an industry leader. You’ll be joining a company...Remote workClaimsFull timeContract workFlexible hours- ...efficiently dispute underpaid claims, reduce administrative burden,... ...the Role We’re looking for a Staff Accountant to join our growing... ...payable end-to-end, including reviewing and coding invoices for... ...talent outside those regions. Remote and hybrid flexibility varies...Remote workClaimsFull timeFlexible hours
- ...Team Leader Position Blue Water Benefits Administrators is seeking... ...support resource for our claims and customer service teams. This... ...backlogs require Request and review additional documentation to... ...Comprehensive benefits package Remote-friendly work environment...Remote workClaims
- Team Leader of Client ServiceLewisville, TX/Tallahassee, FL/Springfield... ...and conduct performance reviews• Handle customer complaints and... ...process, will not be eligible to claim related fees and the submitted... ...allow, CSC offers hybrid or remote work schedules in alignment with...Remote workClaimsLocal areaWorldwide3 days per week
$112.7k - $193.2k
...Connect and InterQual Medical Review Service are Optum's flagship clinical... ...enjoy the flexibility to work remotely * from anywhere within the U.S... ...(including major EHR and UM platform vendors). Maintain... ...management, prior authorization, or claims systems, including clinical...Remote workClaimsMinimum wageFull timeWork experience placementWork at officeLocal area- Team Leader of Software DevelopmentRemote-USMonday to Friday 8:00 am... ...coding standards, code reviews, and engineering best practices... ...process, will not be eligible to claim related fees and the submitted... ...needs allow, CSC offers hybrid or remote work schedules in alignment...Remote workClaimsH1bLocal areaWorldwide
- ...Culture, Great Rewards, and Great Careers.GEICO is seeking a Staff Counsel Procedural Reviewer, Attorney to join our Staff Counsel team. Job duties... ...insurance defense or personal injury.Location: REMOTE#LI-MD2Annual Salary$134,275.00 - $210,125.00The above annual...Remote workHourly payWork experience placementWork at officeLocal areaImmediate start
$150k - $180k
...Attorney to join our growing Staff Legal office in Dallas... ...Zurich North America Claims we acknowledge that... ...and be able to handle remote team based work which requires... ...of billables and diary review with substantive and... ...North America is a leader in risk management, with...Remote workClaimsTemporary workWork at officeLocal areaFlexible hours1 day per week- ...Utilization Review Nurse Join our team at Cobalt Benefits Group... ...collaborates closely with intake staff, physicians, specialists, case... ...activities. Review medical claims and pre-determinations for... ...year of Utilization Management (UM) or Utilization Review (UR) experience...Remote workClaimsFull timeTemporary workSummer workWork at officeFlexible hours
- ...Description The utilization review and management (UM) component program ensures... ...logging and documentation of claims along the process chain. #... ...Work closely with medical staff, case managers, and other healthcare... ...This is an in-office, no remote work capability position...Remote workClaimsWork at office
$152k - $242k
...President, Global Healthcare Product Leader serves as the senior product... ...Legal, Compliance, Actuarial, Claims, Risk Control, Operations,... ...between a CNA office and remote work from home. While Chicago,... ...underwriting guidance, or governance review.Leads product assessments and...Remote workClaimsFull timeWork experience placementWork at officeWork from home- ...Dane Street, LLC is seeking Board Certified Physicians to join our Disability Peer Review team. This telework opportunity allows physicians to evaluate disability claims remotely, offering complete flexibility in scheduling and the ability to dictate workload based on...Remote workClaimsWork from home
- ## Lead Staff Counsel Procedural Review Auditor - AttorneyApply: Remote: Remote (United States): Full time: Posted Today: R0066104**Why Join GEICO?**At GEICO, we offer a rewarding career where your ambitions are met with endless possibilities.Every day we honor our iconic...Remote workHourly payFull timeWork experience placementWork at officeLocal areaImmediate start
$57.97k - $103.87k
.... USAA roles may offer remote or hybrid flexibility for... ...for our Fairfax, VA staff counsel law office.... ...dedicated Legal Assistant (BI/UM), you will provide... ...with legal work which is reviewed and approved by the supervising... ...motor vehicle accident claims, insurance coverage...Remote workClaimsContract workH1bWork at officeWork from homeRelocation packageFlexible hours$41.75 per hour
...Representative - Special Education Claims Background on the... ...litigation experience to Work Remotely on a 1 plus year assignment.... ...Documentation: Prepare and review all necessary filings, agreements... ...attorneys; provide training to field staff and clinical staff on...Remote workClaimsContract workWork at officeLocal areaEarly shift- ...ages (pediatric to geriatric), remote village travel to provide... ...Perform Oral Cancer Screenings. • Review medical and dental histories.... ...for both patients and staff. • Support Prevention Coordinator... ...Program. • Provide after-hours "Dentist Available" services as...Remote workContract workLocal area
- ...Inpatient Um Clinician Our client, a Medical Center... ...their Charlestown, MA/Remote location.... ...Performs utilization review activities, including concurrent... ...interacting with physicians and staff, and ensures compliance... ...negotiation accurately for proper claims adjudication Identify...Remote workClaimsWork at office
- ...throughout the Kodiak Archipelago. As a Staff Dentist, you'll have the opportunity to practice... ...health of patients in both Kodiak and remote village communities. Benefits & Perks... ...quality improvement initiatives, peer review activities, chart audits, and clinical performance...Remote workTemporary workRelocation
$67k - $107.2k
...leading a team of departmental staff, including oversight of... ...random audits of the team’s work. Review audit results with employees... ...giving you flexibility to work remotely with intentional in-person... ...organizations, and internet sites claiming to represent Blue Cross and...Remote workClaimsTemporary workWork at officeLocal areaFlexible hours2 days per week- ...established industry player is seeking a Medical Review Nurse to join their dynamic team in... ...reviewing and adjudicating medical claims, ensuring compliance with industry standards... ...enjoying the flexibility of a primarily remote work environment. If you are passionate about...Remote workClaims
$128k - $192k
...Join the In‑house Senior Staff Attorney – Insurance Defense position... ...at The Hartford. This fully remote role allows litigation across... ...Responsibilities Work closely with claim centers and insureds to... ...Participate in claims file reviews. Conduct trials, depositions...Remote workClaimsTemporary work
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