Physical Therapist, Occupational Therapist – Therapy Services Reviewer
Elevance Health
full-time
Posted on:
Location Type: Remote
Location: Remote • 🇺🇸 United States
Visit company websiteJob Level
Junior
About the role
- The Therapy Services Reviewer is responsible for the review of medical records to determine if requests for therapy services (physical therapy, occupational therapy) were medically necessary and filed appropriately.
- Follows the system guidelines that makes decisions on approval for care for a patient.
- Processes system generated decisions for authorization requests, meeting all contract requirements, processes, and operational unit goals to ensure customer satisfaction.
- Documents findings, develops analyses, and submits reports to the appropriate departments in accordance with government regulations and requirements.
- Researches and obtains additional data, consults with clinical reviewers and medical directors, when necessary.
- Acts as a resource for internal and external customers.
- May participate in intradepartmental teams, projects, and initiatives.
- Maintains quality and productivity standards and ensures reviews are conducted within required timeframes.
Requirements
- Requires graduate of a college level program in physical therapy, occupational therapy, or speech language pathology or an accredited two-year program for a Physical Therapist Assistant, Occupational Therapist Assistant, or Speech Language Pathologist Assistant and minimum of 1 year of clinical experience; or any combination of education and experience, which would provide an equivalent background.
- Current active unrestricted license or certification as a physical therapist assistant, occupational therapist assistant, or speech language pathologist assistant in applicable state required.
- Certification and/or licensure appropriate to field of specialty is required.
Benefits
- merit increases
- paid holidays
- Paid Time Off
- incentive bonus programs
- medical, dental, vision
- short and long term disability benefits
- 401(k) +match
- stock purchase plan
- life insurance
- wellness programs
- financial education resources
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
medical record reviewtherapy services authorizationdata analysisreport submissionclinical consultation
Soft skills
customer satisfactionteam collaborationresourcefulnessquality assurancetime management
Certifications
physical therapist assistant licenseoccupational therapist assistant licensespeech language pathologist assistant license