Dental Services Analyst
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About The Position
The Dental Services Analyst is responsible for the analysis of dental claims, radiographs, patient histories and other records to ensure consistent application of and compliance with policy and departmental guidelines. This position involves identifying and reporting on typical patterns of care, acting as a liaison between consultants, providers, members and operational departments to resolve unusual problems and complex cases, making independent decisions regarding benefit eligibility, providing expert analysis and testimony to corporate appeals and grievances, coordinating utilization review, and reporting savings while recommending procedural and policy changes to maintain or increase revenue.
