Physical Therapist or Occupational Therapist Reviewer (PRN)

Acentra Health; Vancouver (WA); Remote; USD 60,000 - 80,000; Full time

Job summary

Acentra Health is seeking a Physical or Occupational Therapist Reviewer for remote utilization review based in Oregon. This role involves assessing therapy services, ensuring compliance with regulations, and reviewing medical necessity. Qualified candidates will hold an active Oregon license and have relevant experience in a similar capacity.

Benefits

Comprehensive health plans

Paid time off

Retirement savings

Corporate wellness

Educational assistance

Corporate discounts

Qualifications

• Active and unrestricted license for Oregon.
• Minimum two years of experience in physical or occupational therapy, preferably in utilization review.
• Bachelor's degree from accredited college.

Responsibilities

• Review medical records and DME orders to ensure medical necessity.
• Assess therapy plans for compliance with OHA guidelines.
• Approve or deny claims based on criteria.

Skills

Utilization Review

Communication

Assessment

Education

Bachelor's Degree in Physical Therapy or Occupational Therapy

Job description

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 mission of the company; to actively engage in problem-solving; and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities. In fact, 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.

Job Summary and Responsibilities

Acentra Health is looking for a Physical Therapist or Occupational Therapist Reviewer to join our growing team.

Job Summary :

The PRN Physical Therapist Reviewer or Occupational Therapist Reviewer will work in utilization review, ensuring that therapy services are appropriate, necessary, and covered by insurance.

• This is a remote position based within the State of Oregon or neighboring region within 45 minutes of the Oregon border. There may be occasional in-person meetings in Portland, OR.

Responsibilities :

• Review medical records and DME orders to ensure treatments align with medical necessity and OHP benefit OARs
• Assess therapy plans for compliance with OHA guidelines
• Communicate with providers and team members to clarify treatment plans and medical records, written or as otherwise requested
• Approve or deny claims based on established criteria
• Stay updated on healthcare regulations and OHA policies
• Participate in committees to review related DME policies
• Ensure compliance with industry standards and regulations
• Participate in medical committees to discuss individual cases and provide rationale for recommendations
• Provide recommendations for continued or modified therapy
• Evaluate therapy documentation to confirm appropriate interventions
• Analyze treatment effectiveness in individual cases
• Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules.

Qualifications

Required Qualifications

• Active and unrestricted license for the State of Oregon as a physical therapist or occupational therapist
• Minimum of a bachelor's degree from an accredited college or university preferably in a physical therapy or occupational therapy program
• Minimum of two years of experience in physical therapy or occupational therapy with a preference in utilization review, discharge planning, or case management

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 their 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 across the country. We are a company that cares about our employees, and we give you the tools and encouragement you need to achieve the finest work of your career.

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.

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 who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Acentra Health and invite you to apply to 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 /

EEO 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.

Compensation

The pay for this position is listed below.

• We are currently offering a $1,500 sign on bonus for this position.

Based on our compensation philosophy, an applicant's position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level."

LI-AF1

Pay Range

USD $35.30 - USD $55.00 / Hr.

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