Clinical Review Registered Dental Hygienist - Hybrid near Queens, NY

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.

The Clinical Review RDH is a production role that supports the dental director on appealed claims. Solid knowledge of dental procedures, terminology and related dental codes along with solid computer and communication skills are crucial to this role.

If you are located in in New Hyde Park NY, you will have the flexibility to work from home and in the office in this hybrid role* as you take on some tough challenges.

Primary Responsibilities:

• Review of claims and supporting clinical data to provide accurate documentation for the dental director
• Accurate interpretation of radiographs, intra-oral photographs and clinical narratives
• Maintain organization and department defined standard of performance to meet metrics
• Communication with provider offices in accordance with compliance regulations to discuss adverse clinical determinations and to request missing information
• Independently manage individual queue assignments and workflow to meet deadlines, business needs and department and individual metrics
• Acts as a liaison between our dental directors and provider offices to maintain provider/member satisfaction

This is a hybrid position and requires candidates to be available to work 2 days in the New Hyde Park, NY office and 3 days remotely.

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• Registered Dental Hygienist (RDH) with an active, unrestricted license
• 5+ years of dental hygiene clinical practice experience
• Proven solid knowledge of dental terminology and CDT dental codes

Preferred Qualifications:

• 1+ years of insurance experience processing dental claims
• Experience with reading ADA forms, Explanation of benefits, claims and appeals
• Demonstrated familiarity with current dental issues and practices
• Proven solid computer skills in Microsoft Excel and Word
• Proven effective communication skills
• Managed care experience

The hourly range for this role is $28.61 to $56.06 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far- reaching choice of benefits and incentives.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.