Therapy Services Reviewer

Elevance Health

Therapy Services Reviewer responsible for reviewing therapy service requests for medical necessity and compliance with regulations. Ensures authorizations meet contract requirements while maintaining customer satisfaction.

Posted 5/14/2026full-timeNashville • Tennessee, Texas • 🇺🇸 United StatesJuniorWebsite

About the role

Key responsibilities & impact

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

What you’ll need

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

Comp & perks

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

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

medical record reviewtherapy services authorizationdata analysisreport submissionclinical consultation

Soft Skills

customer satisfactionteam collaborationresourcefulnesstime managementquality assurance

Certifications

physical therapist assistant licenseoccupational therapist assistant licensespeech language pathologist assistant license