Hybrid Physical Therapist, Occupational Therapist – Therapy Services Reviewer

at Elevance Health

• Job title: Physical Therapist, Occupational Therapist – Therapy Services Reviewer
• Job type: Full Time
• Experience level: Junior
• Salary: Not specified
• Degree requirement: Associate's Degree
• Location requirements: Hybrid, Indianapolis, United States

About the role

• Reviewing medical records to assess therapy service requests at Elevance Health. Ensure compliance with regulations and maintain high quality and productivity standards.

Responsibilities

• The Therapy Services Reviewer is responsible for the review of medical records to determine if requests for therapy services (physical therapy, occupational therapy) were medically necessary and filed appropriately.
• Follows the system guidelines that makes decisions on approval for care for a patient.
• Processes system generated decisions for authorization requests, meeting all contract requirements, processes, and operational unit goals to ensure customer satisfaction.
• Documents findings, develops analyses, and submits reports to the appropriate departments in accordance with government regulations and requirements.
• Researches and obtains additional data, consults with clinical reviewers and medical directors, when necessary.
• Acts as a resource for internal and external customers.
• May participate in intradepartmental teams, projects, and initiatives.
• Maintains quality and productivity standards and ensures reviews are conducted within required timeframes.

Requirements

• Requires graduate of a college level program in physical therapy, occupational therapy, or speech language pathology or an accredited two-year program for a Physical Therapist Assistant, Occupational Therapist Assistant, or Speech Language Pathologist Assistant and minimum of 1 year of clinical experience; or any combination of education and experience, which would provide an equivalent background.
• Current active unrestricted license or certification as a physical therapist assistant, occupational therapist assistant, or speech language pathologist assistant in applicable state required.
• Certification and/or licensure appropriate to field of specialty is required.

Benefits

• Merit increases
• Paid holidays
• Paid Time Off
• Incentive bonus programs
• Medical benefits
• Dental benefits
• Vision benefits
• Short and long term disability benefits
• 401(k) + match
• Stock purchase plan
• Life insurance
• Wellness programs
• Financial education resources