Clinical Reviewer

About Beam:

Beam was founded in 2012 by three engineers who saw the opportunity to modernize the dental benefits industry using technology. Today, Beam Benefits is a digitally-led employee benefits company that offers dental, vision, life, disability, and supplemental health coverage. The company simplifies and modernizes the $100 billion ancillary benefits industry through its leading dental insurance product, breadth of ancillary benefits, AI-powered underwriting, diversified distribution channels, and next generation benefits administration technologically-driven customer experience.

The Role:

Beam is seeking two Clinical Reviewers to join our growing team. As we continue to scale, clinical review of claims and utilization management becomes an increasingly critical component of Beam’s business. The Clinical Reviewer will be responsible for managing claims throughout their lifecycle, reviewing claims that are not auto-adjudicated, analyzing provider and member inquiries, and reviewing x-rays, charting, and narratives to assess the clinical efficacy of treatment plans. You will play an essential role in ensuring Beam operates as a world-class dental benefits provider by enhancing the efficiency and effectiveness of our claims deliverables to both customers and internal teams.

What You Will Bring:

The ideal candidate is self-motivated, adaptable, and passionate about driving operational efficiency. You have a strong understanding of dental claims and clinical review, with an excellent eye for detail and a proven history of improving processes. You thrive in a high-volume, fast-paced environment and are committed to continuous learning and adapting to new technologies. Your clinical background equips you to interpret treatment plans and review claims effectively, while your problem-solving skills help you navigate complex claims situations.

• Working in a complex and dynamic business, simultaneously serving customers across employee benefits insurance product lines and growth and service channels
• Collaborating with a diversely skilled team to continuously improve
• Being empowered as an owner and expert
• Being motivated by improving how people access employee benefits

• Manage claims throughout their lifecycle, ensuring accurate and efficient processing of claims that are not auto-adjudicated
• Review clinical documentation such as x-rays, charting, and narratives to assess the clinical efficacy of treatment plans
• Analyze provider and member inquiries on finalized claims, including reviewing provider feedback and addressing questions regarding coverage decisions
• Develop a deep understanding of claims coverage rules and clinical efficacy requirements, using this knowledge to improve claims processing and operational efficiency
• Drive efficiency within the clinical review process by streamlining workflows and improving processes to scale resources effectively
• Collaborate with internal teams and external partners to ensure accurate claims review, resolution, and ongoing process improvements
• Additional responsibilities may be assigned as needed to meet business objectives

• 5 years of experience in insurance back-office functions or clinical roles, preferably in dental insurance, clinical review, or dental-related operations
• Proficient in dental insurance coding and claims processing, with the ability to review and assess treatment plans effectively
• Experience interpreting dental health information from x-rays, charting, narratives, and dental history to evaluate clinical efficacy
• Strong organizational skills with the ability to manage multiple claims and tasks simultaneously in a high-volume, fast-paced environment
• Excellent attention to detail and accuracy when reviewing clinical documentation and claims to ensure proper evaluation and processing
• Experience working with utilization management (UM) and clinical review, providing oversight for claims and treatment plans
• Familiarity with new technologies and platforms; ability to quickly learn and adapt to new tools and systems
• Self-motivated and results-driven, with a demonstrated ability to identify areas for improvement and implement operational efficiencies
• Ability to work with remote teams effectively, leveraging technology for seamless collaboration and maximizing face-to-face time where needed

Compensation and Benefits:

Beam offers a competitive base salary paired with an attractive variable compensation structure.

Employees benefit from performance-based bonuses and incentives, along with a comprehensive benefits package that includes health, dental, and vision insurance. Additionally, Beam provides a 401(k) plan with company matching, flexible time off, and the opportunity to participate in the equity program.

The base pay actually offered will take into account internal equity and budget for the open position and also may vary depending on the candidate’s job-related knowledge, skills, and experience, among other relevant factors. This range does not include an estimated value for any benefits, bonus, or other incentives that may be applicable based on position.

Salary : $61,200 - $97,800