Medical Reviewer – Physical Therapist

Gainwell Technologies

Medical Reviewer evaluating physical therapy records, claims, and authorizations for Gainwell Technologies’ California healthcare programs. Supporting clinical necessity and coverage determinations remotely.

Posted 8/22/2026full-timeRemote • California • 🇺🇸 United StatesMid-LevelSenior💰 $85,000 - $100,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in evaluating therapy services, applying clinical judgment, and maintaining compliance with physical therapy standards and medical policies. Proficient in collaborating with healthcare professionals and documenting clinical findings accurately and timely.

Highest-signal resume keywords

Physical Therapy ExperienceCalifornia Physical Therapy LicenseClinical JudgmentMedical Record InterpretationWritten And Verbal Communication Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Clinical Documentation ReviewTreatment Plan EvaluationMedical Policy ApplicationDocumentation AccuracyTherapy Services Evaluation

Soft Skills

CollaborationIndependent WorkProblem-Solving

Tools & Technologies

Computer Systems NavigationHealthcare Applications

Certifications & Qualifications

Professional Certification In Good Standing

Industry Keywords

Medical Review ServicesTreatment Authorization RequestsRegulatory GuidelinesCoverage RequirementsQuality And Productivity Standards

About the role

Key responsibilities & impact

Review physical therapy-related medical records, claims, Treatment Authorization Requests (TARs), treatment plans, and supporting documentation
Evaluate requested therapy services based on clinical documentation, medical policy, and applicable coverage requirements
Apply professional physical therapy principles and clinical judgment when supporting medical necessity and appropriateness determinations
Document review findings and clinical rationale accurately and timely
Refer cases requiring additional clinical review to appropriate medical professionals when needed
Collaborate with physicians, nurses, therapists, operations teams, and other healthcare professionals to resolve review questions
Maintain knowledge of applicable physical therapy standards, medical policies, coverage requirements, and regulatory guidelines
Meet established quality, accuracy, productivity, and turnaround-time expectations
Work primarily from a home office while supporting Medical Review Services for California healthcare programs
Navigate multiple computer systems and applications to complete reviews, document findings, and support timely determinations

Requirements

What you’ll need

Minimum of three (3) years of experience as a Physical Therapist
Graduation from an accredited school of Physical Therapy
California license to practice Physical Therapy, or eligibility for California licensure
Current professional certification in good standing
Strong clinical judgment and ability to interpret medical records, treatment plans, and therapy-related documentation
Strong written and verbal communication skills
Ability to work independently while collaborating effectively with clinical, operational, and cross-functional teams
Maintain all professional licenses, certifications, and credentials required for the position in active and good-standing status, as applicable
Monday through Friday work schedule
Travel requirement: 0-10%

Benefits

Comp & perks

Flexible hours
Work-life balance
Continuous learning and career development
Flexible vacation policy
401(k) employer match
Comprehensive health benefits
Educational assistance
Leadership and technical development academies
Ongoing training and support
Remote work environment