Clinical Research & Escalation Specialist
NCD · United States · US
Utilization Review
Remote
Dentist
Demand68
Career growth62
Healthcare fit74
Remote potential45
5-year outlook
Payer-side claims escalation and utilization-review experience can support progression into senior appeals, compliance, quality, or clinical-review roles. Compensation is not stated and will vary by market and insurer.
Clinical license
Not required
Applicant reach
moderate
Seniority
mid
Employment type
full-time
Date found
2026-10-24
Intelligence details
Flexible work details
- Engagement type
- Permanent
- Hours
- Full-time
- Eligible countries
- United States
- Profession fit
- Dentist
- Rate period
- Annual
Listing via Himalayas.
Eligibility, licensing, and location restrictions can change. Always confirm details on the source posting before applying.
Why this is worth applying to
Worth considering for dental/vision clinicians or clinically trained graduates who want payer-side, non-patient-facing work with claims and appeals exposure. It is less suitable for those seeking true clinical research or highly autonomous remote work.
Who should apply
Dentists, dental hygienists/allied dental professionals, optometry/vision-adjacent clinicians, and healthcare graduates with insurance, claims, coding, or customer-resolution experience.
CV angle
Frame real clinical experience around documentation review, CDT/EOB familiarity, radiograph interpretation, member/patient communication, complaint de-escalation, and cross-functional case resolution. Quantify caseloads, turnaround times, or complex disputes where possible without inventing claims experience.
Skills to highlight
- Dental/vision claims review
- CDT procedure coding
- EOB interpretation
- Clinical documentation and radiograph review
- Root-cause analysis
- Member complaint resolution
- Coordination of benefits
- Cross-functional collaboration
Role summary
Payer-side specialist reviewing escalated dental and vision claims and member complaints, interpreting clinical documentation and EOBs, and coordinating with carriers and providers to resolve disputes and explain outcomes.
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