Physical Therapist Reviewer PRN (Remote - Within Alabama)
Alabama, United States - Remote
Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact.
Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the company's mission, actively engage in problem-solving, and take ownership of your work daily. Acentra Health offers unparalleled opportunities. You have all you need to take charge of your career and accelerate better outcomes, making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector.
Acentra is seeking a Physical Therapist Reviewer PRN to join our growing team.
**MUST RESIDE IN THE STATE OF ALABAMA**
Job Summary:
The Physical Therapist Reviewer PRN is responsible for evaluating medical records against established criteria in accordance with contractual obligations, leveraging clinical expertise, critical thinking, and decision-making skills. They take the lead in ensuring determinations of medical appropriateness align with productivity goals and the quality assurance standards established by the organization.
Requirements
Job Responsibilities:
- Review and interpret patient records and compare against criteria to determine medical necessity and appropriateness of care. Determine if the medical record documentation supports the need for services.
- Determine approval or initiate a referral to the consulting physician and process the physician's decisions, ensuring the reason for the denial is described in sufficient detail on correspondence.
- Abstract review-related data/information accurately and timely.
- Foster positive and professional relationships and consult with internal and external customers to ensure effective working relationships and team building.
- Performs ongoing reassessment of the review process to offer opportunities for improvement and/or change.
- Attend training and scheduled meetings.
- Always maintain medical records confidentiality through proper use of computers and passwords, maintenance of secured files, and adherence to HIPAA policies.
- Perform other duties as assigned.
Required Qualifications/Experience:
- Active and unrestricted Physical Therapy license. Must be registered with both the Alabama Board of Physical Therapy and Board of Medical Examiners.
- Must not currently or in the future be employed with an Alabama Medicaid Provider.
- Reside in the state of Alabama.
- Knowledge of Medicare and Medicaid Wheelchair policies.
- Strong medical record abstracting skills and thorough knowledge of medical records, medical terminology, and disease processes.
- 2+ years of clinical experience in a physical therapy or rehabilitation environment.
Preferred Qualifications/Experience:
- Prior experience or knowledge of durable medical equipment prior authorization requirement.
- Excellent written and verbal communication skills.
- Strong clinical assessment and critical thinking abilities.
- Ability to work collaboratively.
- Ability to change or adapt quickly to accommodate different situations.
- Strong organizational skills.
- Proficiency in Microsoft Office.
- Initiative-taking and driven to achieve productivity goals.
- Possess an elevated level of self-motivation.
- Demonstrated enthusiasm for achieving personal and professional goals.
Benefits
Why us?
We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as a vital partner to ensure better healthcare and improve health outcomes.
We do this through our people.
You will have meaningful work that genuinely improves people's lives nationwide. Our company cares about our employees, giving you the tools and encouragement you need to achieve the finest work of your career.
Benefits
Benefits are a key component of your rewards package. Our benefits are designed to provide you with additional protection, security, and support for both your career and your life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.
Compensation
The pay range for this position is $42.00/hr - $49.00/hr
“Based on our compensation program, an applicant’s position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level.”
Thank You!
We know your time is valuable, and we thank you for applying for this position. Due to the high volume of applicants, only those chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Acentra Health and invite you to apply for future openings that may be of interest. Best of luck in your search!
~ The Acentra Health Talent Acquisition Team
Visit us at Acentra.com/careers
EOE AA M/F/Vet/Disability
Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by applicable Federal, State, or Local law.
ApplyJob Profile
Cannot be employed with Alabama Medicaid provider Must reside in Alabama
Benefits/PerksCollaborative team environment Comprehensive health plans Corporate Discounts Corporate wellness Educational Assistance Equal opportunity employer Health plans Health solutions Health solutions innovation Meaningful work Paid Time Off Professional growth Protection Retirement Retirement savings Security Support Unparalleled opportunities
Tasks- Attend training
- Communication
- Determine medical necessity
- Documentation
- Evaluate medical records
- Foster relationships
- Maintain confidentiality
- Perform reassessments
- Training
Assessment Clinical assessment Clinical Experience Clinical expertise Communication Consulting Critical thinking Disease Processes Documentation Healthcare Healthcare industry HIPAA Medicaid Medicaid Policies Medical necessity Medical record abstracting Medical Record Review Medical Records Medical terminology Medicare Medicare Policies Microsoft Office Organizational Physical therapy Prior authorization Problem-solving Public Sector Quality Assurance Rehabilitation Strong organizational Talent Acquisition Training Verbal communication
Experience2 years
Education Certifications TimezonesAmerica/Anchorage America/Chicago America/Denver America/Los_Angeles America/New_York Pacific/Honolulu UTC-10 UTC-5 UTC-6 UTC-7 UTC-8 UTC-9