ApplyBlast uses AI to match you with the right jobs, tailor your resume and cover letter, and apply automatically so you can land your dream job faster.

Features

Auto Apply Resume Optimizer Cover Letter Optimizer Interview Prep

Company

Social Media

Need Help?

team@applyblast.com

Advanced Therapy Services Reviewer at Elevance Health - ApplyBlast

Advanced Therapy Services Reviewer

Elevance Health

3 months ago

3.4 on Glassdoor

Indianapolis, Indiana

Hybrid

Full Time

Senior

0 applicants

View Job Listing

Apply to 100+ jobs

About this role

The Advanced Therapy Services Reviewer conducts clinical case evaluations to determine the medical necessity of therapy service requests, ensuring compliant and consistent decision-making. This role involves leading peer-to-peer calls with providers, rendering adverse determinations, and documenting findings in accordance with regulatory standards. The position supports medical management staff by applying company policies to physical, occupational, and speech-language pathology cases.

Responsibilities

Conduct clinical case reviews to assess medical necessity of therapy services
Lead peer-to-peer calls with therapist providers to gather clinical information
Render adverse determinations for specific clients when appropriate
Document findings and submit reports in compliance with regulatory standards
Escalate cases requiring Medical Director review or policy interpretation

Skills

Qualifications

BA/BS in Physical Therapy, Occupational Therapy, or Speech-Language PathologyActive and Unrestricted License as a Physical Therapist, Occupational Therapist, or Speech-Language PathologistMaster's degree in Physical Therapy, Occupational Therapy, or Speech-Language Pathology (Preferred)