Dental Utilization Review Analyst is responsible for evaluating proposed dental services to ensure proposed treatments are medically necessary, cost-effective, and comply with clinical guidelines and policy coverage. Utilizes clinical criteria and evidence-based guidelines to evaluate the necessity and appropriateness of treatments as well as compliance of utilization review guidelines. Being a Dental Utilization Review Analyst reviews patient records, X-rays, and clinical documentation to approve or deny proposed procedures. May require a bachelor's degree. Additionally, Dental Utilization Review Analyst typically reports to a manager. The Dental Utilization Review Analyst occasionally directed in several aspects of the work. Gaining exposure to some of the complex tasks within the job function. To be a Dental Utilization Review Analyst typically requires 2-4 years of related experience.
