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 analyze clinical documentation to approve services meeting clinical review criteria
• Conduct audits and monitor quality of care standards within the provider network

Required Qualifications and Education

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