Office/Professional
Dental Hygiene Authorization Analyst – Temporary
Location: Oklahoma City, OK
Schedule: Full-Time, Temporary
Work Environment: Office-based; candidates may be required to attend an in-person interview in Oklahoma City.
Position Overview
A healthcare organization is seeking an experienced Dental Hygienist for a temporary Dental Hygiene Authorization Analyst position.
This is a unique opportunity for a licensed Dental Hygienist who is interested in transitioning from a traditional clinical environment into a more administrative, analytical, and office-based role while still utilizing their dental knowledge and experience.
The Dental Hygiene Authorization Analyst will review and analyze dental service authorization requests, clinical documentation, dental and medical records, and supporting information to determine whether requested services meet established guidelines and medical necessity requirements.
This position is ideal for someone who has strong clinical dental hygiene experience but also enjoys reviewing documentation, analyzing information, working independently, maintaining accuracy, and making informed decisions based on established criteria.
Key Responsibilities
- Review and analyze dental prior authorization requests and supporting clinical documentation.
- Interpret dental and medical records, provider statements, treatment information, and related documentation.
- Evaluate requests to determine whether established eligibility, clinical, and authorization criteria are met.
- Review periodontal treatment requests and determine whether services meet established medical necessity requirements.
- Approve requests that meet established criteria and refer cases requiring additional clinical review to the appropriate dental consultant.
- Collaborate with dentists, clinical consultants, and internal teams when additional technical or clinical guidance is necessary.
- Apply established policies, procedures, regulations, and clinical criteria consistently when reviewing requests.
- Identify potential concerns involving utilization, billing practices, documentation, or authorization requirements.
- Maintain accurate records and documentation related to authorization decisions.
- Create and maintain spreadsheets and tracking information for the dental program.
- Identify potential system or process issues and collaborate with appropriate internal teams to resolve them.
- Assist with dental-related projects and special initiatives.
- Participate in internal and external meetings as needed.
- Assist with meeting preparation, documentation, and meeting minutes.
- Maintain confidentiality when handling sensitive dental, medical, and member information.
- Manage a high volume of reviews while maintaining accuracy, quality, and established deadlines.
Required Qualifications
- Current, valid Oklahoma Dental Hygienist license
- Dental Hygiene certificate or degree from an accredited dental hygiene program
- Minimum of 5 years of clinical experience as a Dental Hygienist
- Strong knowledge of:
- Dental hygiene principles and practices
- Dental terminology and procedures
- Periodontal conditions and treatment
- Standards of dental care
- Dental and medical records
- Clinical documentation
- Strong analytical and critical-thinking skills.
- Excellent attention to detail and accuracy.
- Ability to interpret clinical information and consistently apply established criteria.
- Strong written and verbal communication skills.
- Ability to work independently with limited supervision.
- Strong organizational and time-management skills.
- Ability to manage competing priorities and productivity expectations.
- Sound judgment and ability to recognize when additional clinical review is necessary.
- Ability to maintain confidentiality and appropriately handle sensitive information.
Preferred Qualifications
Preference may be given to candidates with:
- Experience working with healthcare coverage programs or insurance
- Experience with medical or clinical review
- Bachelor’s degree in Dental Hygiene
- Advanced degree such as an MPH, MPA, MPM, or M.Ed.
- Experience reviewing clinical documentation or authorization requests
- Strong Excel/spreadsheet experience