State Licensed Clinical Reviewer

Job Summary

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

Key Responsibilities

• Evaluate cases that do not pass the authorization approval process and collaborate with call center staff
• Review charts and clinical documentation to approve services meeting review criteria
• Conduct audits and monitor quality of care standards within the provider network

Required Qualifications

• Current, unrestricted state licensure as a Physical Therapist
• Physical therapy degree from an accredited program and national certification examination passed
• 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