Top 89 Dental clinical reviewer Jobs in Remote

Dispute Resolution Reviewer III (Healthcare Professional)
TMF Health Quality Institute —Remote
- Full-time
- Remote
- Writing skills
- Research
- Mid-level
- AD&D insurance
- Disability insurance
Initial Clinical Reviewer
Enlyte —Remote
- $59,000 - $73,000 a year
- Full-time
- Remote
- Clinic experience
- Mid-level
- Analysis skills
- Health savings account
- AD&D insurance
5d
Dispute Resolution Reviewer I
TMF Health Quality Institute —Remote
- Full-time
- Remote
- Research
- Mid-level
- Associate's degree
- AD&D insurance
- Disability insurance
Nurse Reviewer
Staffing Solutions Organization LLC —Remote
- $73,000 - $81,000 a year
- Full-time
- Remote
- Experience working with individuals with developmental disabilities
- Nursing
- Microsoft Outlook
- Paid holidays
- Health insurance
Quick Apply
NSQIP Surgical Clinical Reviewer: Full-Time
Q-Centrix —Remote
- $34 - $38 an hour
- Full-time
- Remote
- Surgery
- Mid-level
- Microsoft Office
- Paid parental leave
- Health savings account
Quick Apply
Complex Medical Bill Reviewer
Enlyte —Remote
- $53,500 - $70,000 a year
- Full-time
- Remote
- Surgery
- LVN
- RN License
- Health savings account
- AD&D insurance
Surgical Clinical Reviewer (NSQIP) Team Lead
Q-Centrix —Remote
- $39 - $41 an hour
- Full-time
- Remote
- Surgery
- Mid-level
- Microsoft Office
- Paid parental leave
- Health savings account
Quick Apply
Medical Peer Reviewer
Healthfirst —Remote
- $122,907 - $188,020 a year
- 8 hour shift
- Medicine
- Mid-level
- Communication skills
- Paid holidays
- Health insurance
Sr. Manager of Member Engagement
Private Health Management —Remote
- $120,000 - $180,000 a year
- US work authorization
- Senior level
- Leadership
- Health insurance
- Dental insurance
Quick Apply
DRG Reviewer
Machinify —Dallas, TX
- $90,000 - $115,000 a year
- Remote
- Nursing
- HIPAA
- Mid-level
- Health savings account
- Health insurance
Quick Apply
Medical Consultant Reviewer - Internist PRN or Part-Time
COMAGINE HEALTH —Washington, DC
- $140 - $148 an hour
- Part-time
- Remote
- Medicine
- Internal Medicine
- Travel
- Paid parental leave
- Health insurance
Quick Apply
Medical Front Office Coordinator (AI Model Training)
FIND Healthcareers —New York, NY
- Temporary
- Remote
- Spanish
- English
- Mid-level
Quick Apply
Audit Reviewer (RN -Med/Surg)
Knowtion Health —Remote
- Full-time
- Remote
- Mid-level
- 3 years
- Medical-Surgical
- Paid holidays
- Disability insurance
Quick Apply
Utilization Management Physician Reviewer
Oak Street Health —Illinois
- $174,070 - $374,920 a year
- Full-time
- Remote
- Medicine
- Mid-level
- US work authorization
- Health insurance
- Dental insurance
DRG Reviewer
MedReview —Remote
- $85,000 - $90,000 a year
- Full-time
- Remote
- Microsoft Outlook
- Computer literacy
- Mid-level
- Commuter assistance
- Health insurance
Quick Apply
4d
Product Reviewer
G-MED NORTH AMERICA, Inc. —Remote
- Full-time
- Remote
- Mid-level
- 4 years
- Commuter assistance
- Paid parental leave
Quick Apply
Medical Director Associate (contract)
Elevance Health —Remote
- $89.44 - $170.79 an hour
- Contract
- Remote
- Medicine
- HIPAA
- Analysis skills
- Health savings account
- Disability insurance
5d
Clinical Denials and Appeals Specialist
UASI —Remote
- Remote
- Microsoft Word
- Nursing
- RN License
- Disability insurance
- Health insurance
2d
Clinical Documentation Integrity - Second Level Reviewer
University of Miami —Hialeah, FL
- Full-time
- Remote
- Nursing
- Medicine
- Microsoft Excel
- Health insurance
- Dental insurance
Associate Research Director - Complex Care
Private Health Management —Remote
- $110,000 - $125,000 a year
- Remote
- Analysis skills
- Doctor of Philosophy
- US work authorization
- Health insurance
- Dental insurance
Quick Apply

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dental clinical reviewer jobs near remote

Dispute Resolution Reviewer III (Healthcare Professional)

TMF Health Quality Institute -
Remote

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Job Details

Full-time

Benefits

License reimbursement
AD&D insurance
Disability insurance
Health insurance
Dental insurance
401(k)
Tuition reimbursement
Vision insurance
Life insurance

Qualifications

Research

Full Job Description

Category: Program Management

Requisition Number: DRRII001384

Posting Details

- Posted: June 4, 2026
Full-Time
Locations

Remote, Anywhere USA

Job Details

Description

**Please make sure your application is complete, including your education, employment history, and any other applicable sections. Initial screening is based on the minimum requirements as defined in the job posting, such as education, experience, licenses, and certifications. Your experience should also address the knowledge, skills and abilities needed for the role. Incomplete applications will not be considered.**

*This position is located Remote United States*

Position Purpose:

Provides dissatisfied patients/beneficiaries and/or providers the opportunity to present documentation to demonstrate why an appeal/dispute should be allowed. Provides an independent second level determination/dispute resolution based on the documentation, facts, laws, regulations, and guidelines.

Essential Responsibilities:

Reviews medical records/case file, writes a reconsideration/dispute resolution decision that is clear, concise, and impartial and supports the determination made, and documents review.
Makes sound, independent decisions based on medical evidence in accordance with statutes, regulation, rulings, and policy.
Responds to and ensures that all appeal/dispute issues raised by the beneficiary/patient, representative, and provider/supplier have been addressed.
Provides a fair and impartial decision based on current evidence, regulations, policies, and procedures.
Conducts research using online federal regulations, contract policy, standards of medical practice, contract manuals, coverage issues manuals, medical literature, and other related resources to complete an accurate and well-supported decision.
Stays abreast of changes in regulations, medical and healthcare practices, policies and procedures.

Minimum Qualifications

Education

Associate's degree or 60 or more credit hours towards a Bachelor’s degree from an accredited college or university in healthcare or related discipline
- Additional experience in Medicare appeals, medical review, clinical, or other related experience in a healthcare setting may be substituted for Associate’s degree on a year per year basis. (Experience requirements may be satisfied by full-time experience or the prorated part-time equivalent.)

Experience

Three (3) years of medical dispute resolution or Medicare appeals, medical review, clinical, or related experience in a healthcare setting
Healthcare Professional with Nursing, Physical Therapy, Respiratory Therapy or Occupational Therapy experience
- Juris Doctorate or Master’s Degree in Healthcare or related discipline may be substituted for Healthcare Professional with Nursing, Physical Therapy, Respiratory Therapy or Occupational Therapy experience

Demonstrated experience writing or making appeal or payment determinations
Independent Dispute Resolution, preferred
Resided in the United States for a minimum of three (3) years out of the last five (5) years (Per Contract Requirement)

Benefits

C2C offers an excellent benefits package, including:

Medical, dental, vision, life, accidental death and dismemberment, and short and long-term disability insurance
Section 125 plan
401K
Competitive salary
License/credentials reimbursement
Tuition Reimbursement

EOE Vet/Disability

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

Apply Now

Refine Your Search

dental clinical reviewer jobs in remote

Dispute Resolution Reviewer III (Healthcare Professional)

Initial Clinical Reviewer

Dispute Resolution Reviewer I

Nurse Reviewer

NSQIP Surgical Clinical Reviewer: Full-Time

Complex Medical Bill Reviewer

Surgical Clinical Reviewer (NSQIP) Team Lead

Medical Peer Reviewer

Sr. Manager of Member Engagement

DRG Reviewer

Medical Consultant Reviewer - Internist PRN or Part-Time

Medical Front Office Coordinator (AI Model Training)

Audit Reviewer (RN -Med/Surg)

Utilization Management Physician Reviewer

DRG Reviewer

Product Reviewer

Medical Director Associate (contract)

Clinical Denials and Appeals Specialist

Clinical Documentation Integrity - Second Level Reviewer

Associate Research Director - Complex Care

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