Clinical Reviewer – Registered Dental Hygienist – Telecommute

UnitedHealth Group
October 3, 2021
Houston, TX
Job Type


Expanding access to affordable, high quality health care starts here. This is where some of the most innovative ideas in health care are created every day. This is where bold people with big ideas are writing the next chapter in health care. This is the place to do your life's best work.(sm)

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

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. 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

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
  • 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
  • Familiarity with current dental issues and practices
  • Solid computer skills in Microsoft Excel and Word
  • Effective communication skills
  • Managed care experience

UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.

Careers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of health care. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is your life's best work.(sm)

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Colorado Residents Only: The salary range for Colorado residents is $53,300 to $95,100. Pay is based on several factors including but not limited to education, work experience, certifications, etc. 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

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.

Job Keywords:  Clinical Reviewer, Registered Dental Hygienist, Dental, RDH, Dental Hygienist, Managed Care, Medicaid, Medicare, Insurance, Telecommute, UnitedHealthcare, UHC, Telecommute, Telecommuter, Telecommuting, Work at Home, Work from Home, Remote

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