State Licensed Clinical Reviewer

Job Summary

A company is looking for a Clinical Reviewer, Physical Therapy - Part Time.

Key Responsibilities

• Evaluate cases that do not pass the authorization approval process and collaborate with call center staff
• Review clinical records to approve services meeting review criteria and conduct regular audits for quality standards
• Communicate with medical office staff regarding approvals and denials, ensuring documentation and compliance with policies

Required Qualifications

• Current, unrestricted state licensure as a Physical Therapist
• Physical therapy degree from an accredited program and passed the national certification examination
• 5+ years of clinical experience preferred
• Not under current exclusion or sanction by any state or federal health care program
• No history of disciplinary or legal action by a state medical board