Dental Appeals & Compliance Analyst

University of Minnesota School of Dentistry; Maryland; Remote; USD 44,000 - 94,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Paid time off

Job summary

CVS Health is seeking a Dental Appeals Specialist in Maryland to support the daily processing of appeals within the Par Provider Dental Appeals program. You will complete determinations, prep dental requests, and update systems while coordinating with clinical support staff in a fast-paced environment.

Responsibilities include case movement in MedHok, adherence to regulatory turnaround times, and identifying trends to propose actionable solutions.

Qualifications

• Understands contemporary dental care standards, practices and procedures.
• Maintains required CE if certified or licensed.
• Works with dental professionals to support appeals processes.

Responsibilities

• Supports daily processing of appeals in the Par Provider Dental Appeals.
• Completes appeals determinations letters and preps dental requests.
• Updates systems and completes required reporting.
• Collaborates with clinical support staff (Medical Directors, Nurses, Providers).
• Manages case movement in the MedHok system.
• Ensures work meets turnaround times and regulatory standards.
• Raises trends and issues; reports and suggests solutions.

Skills

Dental care standards

Radiograph interpretation

Continuing education requirements

Education

Vocational or college training beyond high school

CDA, RDA, RDH with 5+ years clinical experience

Job description

CVS Health is seeking a Dental Appeals Specialist in Maryland to support the daily processing of appeals within the Par Provider Dental Appeals program. You will complete determinations, prep dental requests, and update systems while coordinating with clinical support staff in a fast-paced environment.

Responsibilities include case movement in MedHok, adherence to regulatory turnaround times, and identifying trends to propose actionable solutions.