Clinical Review Specialist

Enlyte

2d • $83,000 - $85,000 • Remote

About The Position

The Clinical Review Specialist is a vital member of the Clinical Oversight Team within Apricus. This role involves reviewing physical therapy services for injured workers to ensure high-quality care and appropriate treatment. You will provide clients with updated clinical summaries and recommendations regarding continuation or discontinuation of therapy services. This position is available as a remote work opportunity with expectations for maintaining confidentiality of company and customer information.

Requirements

• Degree in Physical or Occupational Therapy with active license as Physical/ Occupational Therapist or Physical/ Occupational Therapist Assistant in the United States.
• Experience 3+ years in outpatient therapy setting
• Exceptional communication skills, both written and verbal.
• Ability to provide comprehensive review reports for clients
• Demonstrate ability to meet metrics for reviews case load
• Excellent organizational skills with ability to prioritize work effectively
• Proficiency with company software and equipment

Nice To Haves

• Experience in Workers Compensation Industry
• Knowledge of industry standard treatment guidelines
• Experience in performing quality assessments and/or clinical chart reviews

Responsibilities

• Conduct reviews of physical or occupational therapy evaluation and treatment documentation
• Perform Peer-to-Peer communication with treating or supervising PTs and OTs via phone and/or email to review therapy care plans for injured workers covered by Workers Compensation claims.
• Utilize state and national disability guidelines to assess duration of care and provide clinical recommendations for ongoing therapy or discharge readiness.
• Prepare detailed reports and clinical summaries with written support of recommendations for clients
• Maintain communication with nurse case managers and other claim stakeholders as needed
• Collaborate with operations and clinical admin staff to ensure appropriate authorization
• Perform provider follow up regarding authorization and/or clinical recommendations

Benefits

• Medical
• Dental
• Vision
• Health Savings Accounts / Flexible Spending Accounts
• Life and AD&D Insurance
• 401(k)
• Tuition Reimbursement
• an array of resources that encourage a lifetime of healthier living

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed
• Number of Employees: 1,001-5,000 employees