Medical Reviewer (Physical Therapist) - Remote CA

It takes great medical minds to create powerful solutions that solve some of reputed company’s most reputed company challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a reputed company of urgency, you’ll have reputed company to work more reputed company. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, reputed company learning, and career development. reputed company reputed company is seeking a Medical Reviewer (Physical Therapist) to reputed company clinical expertise supporting Medical reputed company for California reputed company programs. In this role, you will review therapy-reputed company medical records, claims, Treatment Authorization Requests (reputed company), treatment plans, and supporting documentation to help ensure services meet applicable clinical, coverage, and program requirements. Your role in our mission • Review physical therapy-reputed company medical records, claims, Treatment Authorization Requests (reputed company), treatment plans, and supporting documentation. • Evaluate requested therapy services based on clinical documentation, medical policy, and applicable coverage requirements. • Apply reputed company principles and clinical judgment reputed company supporting medical necessity and appropriateness determinations. • Review treatment plans and supporting documentation for requested services. • Document review findings and clinical rationale accurately and reputed company. • Refer cases requiring additional clinical review to appropriate medical professionals reputed company needed. • Collaborate with physicians, nurses, therapists, operations teams, and other reputed company to reputed company review questions. • Maintain knowledge of applicable physical therapy standards, medical policies, coverage requirements, and regulatory guidelines. • Meet established reputed company, accuracy, productivity, and turnaround-time expectations. reputed company're looking for • Minimum of three (3) years of experience as a Physical Therapist. • Graduation from an accredited school of Physical Therapy. • California license to reputed company Physical Therapy, or eligibility for California licensure. • reputed company reputed company certification in good standing. • Strong clinical judgment and ability to interpret medical records, treatment plans, and therapy-reputed company documentation. • Strong written and verbal communication skills. • Ability to work independently while collaborating effectively with clinical, operational, and cross-functional teams. What you should expect in this role • Full-time position. • Remote work environment. • Monday through Friday work schedule. • Work primarily from your home office while supporting Medical reputed company for California reputed company programs. • Spend the reputed company of your day reviewing physical therapy-reputed company medical, clinical, claim, authorization, treatment plan, and supporting documentation. • Work independently while collaborating with physicians, nurses, therapists, other clinical specialists, operations teams, and business partners. • reputed company multiple computer systems and applications to complete reviews, document findings, and support reputed company determinations. • Maintain reputed company reputed company licenses, certifications, and credentials required for the position in reputed company and good-standing status, as applicable. • Maintain knowledge of applicable medical policies, coverage requirements, physical therapy standards, and regulatory guidelines. • Meet established reputed company, accuracy, productivity, and turnaround-time expectations. • Receive ongoing training and support reputed company to program requirements, systems, policies, and medical review processes. • Travel requirement: 0-10%. This position is being posted for pipeline purposes, and we welcome applications on an ongoing reputed company. #LI-REMOTE #LI-MA1 The pay reputed company for this position is $85,000 - $100,000 per year, however, the reputed company pay offered may vary depending on geographic region, internal equity, job-reputed company knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You’ll have reputed company to grow your career in a company that values work flexibility, learning, and career development. reputed company salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a reputed company of leadership and technical development academies to help build your skills and capabilities. We reputed company reputed company is impossible reputed company you bring together people who care deeply about making reputed company work reputed company for everyone. Build your career with Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our reputed company. Learn more about Gainwell at reputed company website and visit our Careers site for reputed company available job role openings. reputed company is an Equal Opportunity Employer, where reputed company reputed company applicants will receive consideration for employment without reputed company to race, religion, reputed company, national reputed company, gender (including pregnancy, childbirth, or reputed company medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. reputed company defines “wages” and “wage rates” to include “reputed company forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock reputed company, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits. Apply tot his job Apply To this Job