Role Overview
Achievers Spot is hiring a mid-level Dentist BHMS BAMS BDS BNYS BUMS. This is a full-time role in IN. posted last week. Full responsibilities, required qualifications, and the apply link are listed in the description below.
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Job Description
Identify cases eligible for medical reviews and assign these to appropriate reviewers.
Reach out to the client for any problems identified in the cases for review.
Adhere to Utilization Review Accreditation Commission (URAC), jurisdictional, and/or established MediCall best practice UM time frames, as appropriate.
Adhere to federal, state, URAC, client, and established MediCall best practice WCUM time frames, as appropriate.
Develop a complete understanding of the Medical management Procedures.
Perform medical review assessment (MRA) on utilization of health services (eg healthcare plans, workers compensation products etc) in an accurate, efficient and timely manner while ensuring compliance with utilization management regulations and adherence to state and federal mandates.
Provide succinct negotiable points based on the submitted medical records that identify necessary medical treatment, casually related care, response or lack of response to treatment, etc.
Identify missing records and information that are necessary in the completion of the medical review assessment.
Adhere to Department of Labor, state and company timeframe requirements.
Coordinates physician reviewer referral as needed and follows up timely to obtain and deliver those results.
Track status of all utilization management reviews in progress and follow up on all pending cases.
Work closely with management team in the ongoing development and implementation of utilization management programs.
Respond to inbound telephone calls pertaining to medical reviews in a timely manner, following client a established protocols.
Process customer calls consistent with program specified strategies and customer satisfaction measurements to include but not limited to proper answering procedure, eg opening and closing remarks.
Learn new methods and services as the job requires.
Medical Coding is the process of conversion of text information related to healthcare services into numeric Diagnosis (Medical Problems) and Procedure (Treatments) Codes using ICD-10 CM and CPT code books.
Requirement
knowledge in Anatomy and Physiology
Good communication and interpersonal skills
Basic Computer Skills
Benefits From Job
- Pick Up Drop Facility
- Food Facility
- Day Shift
- Weekend Off
This job is provided by Shine.com
Frequently Asked Questions
How do I apply for the Dentist BHMS BAMS BDS BNYS BUMS position at Achievers Spot?
Use the Apply button above to submit your application directly to Achievers Spot. Most applications take less than 5 minutes if your resume and contact details are ready, and you'll be routed to the employer's official application system to finish.
Where is the Dentist BHMS BAMS BDS BNYS BUMS position at Achievers Spot located?
This position is based in IN. Achievers Spot has not indicated remote or hybrid options for this role, so candidates should plan for on-site work.
What does a Dentist BHMS BAMS BDS BNYS BUMS at Achievers Spot earn?
Achievers Spot has not disclosed a salary range in this posting. Many employers share specifics later in the interview process; you can also ask during a recruiter screen if compensation transparency is important to you.
When was the Dentist BHMS BAMS BDS BNYS BUMS role at Achievers Spot posted?
This role was posted on June 1, 2026 (12 days ago). It's still listed as actively hiring; we re-confirm openings against the source system multiple times per day and remove closed roles.
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