Medical Reviewer – Speech and Audiology Specialist

Gainwell Technologies

Medical Reviewer applying speech, language, and audiology expertise to California healthcare claims and authorizations. Supporting medical necessity decisions for Gainwell Technologies’ healthcare programs.

Posted 8/22/2026full-timeRemote • California • 🇺🇸 United StatesMid-LevelSenior💰 $80,000 - $100,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in Speech-Language Pathology or Audiology, with a strong focus on evaluating treatment plans and clinical documentation to ensure medical necessity and compliance with professional standards. Proficient in collaborating with healthcare professionals and navigating multiple systems to support timely and accurate review processes.

Highest-signal resume keywords

Speech-Language Pathology ExpertiseAudiology ExpertiseClinical JudgmentCommunication SkillsCalifornia Professional Credentials

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Clinical Documentation ReviewTreatment Plan EvaluationMedical Policy ApplicationRegulatory Guideline KnowledgeClaims Review

Soft Skills

CollaborationIndependent WorkProblem-Solving

Tools & Technologies

Computer Systems NavigationDocumentation Applications

Certifications & Qualifications

Certificate of Clinical Competence in Speech-Language PathologyCertificate of Clinical Competence in Audiology

Industry Keywords

Medical NecessityTreatment Authorization RequestsQuality StandardsProductivity Expectations

About the role

Key responsibilities & impact

Review speech, language, and audiology-related claims, Treatment Authorization Requests (TARs), treatment plans, and clinical documentation
Evaluate requested services based on applicable medical policies, coverage requirements, and professional standards
Apply speech-language pathology or audiology expertise to support medical necessity and appropriateness determinations
Review treatment plans and supporting documentation for requested or billed services
Document review findings, decisions, and supporting clinical rationale accurately and timely
Refer cases requiring additional clinical review to appropriate medical professionals when needed
Collaborate with physicians, nurses, other clinical specialists, operations teams, and business partners to resolve review questions
Maintain knowledge of applicable professional standards, medical policies, coverage requirements, and regulatory guidelines
Meet established quality, accuracy, productivity, and turnaround-time expectations
Navigate multiple computer systems and applications to complete reviews, document findings, and support timely determinations
Support Medical Review Services for California healthcare programs

Requirements

What you’ll need

Minimum of three (3) years of experience as a Speech, Language, or Audiology practitioner
Current California professional credentials as applicable to the discipline
Current Certificate of Clinical Competence in Speech-Language Pathology or Audiology granted by the American Speech-Language-Hearing Association, consistent with applicable program requirements
Strong oral and written communication skills
Strong clinical judgment and ability to interpret clinical records, treatment plans, and supporting documentation
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

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 related to program requirements, systems, policies, and medical review processes