Remote Physical Therapist Medical Reviewer (CA)

Gainwell Technologies; West Sacramento (CA); À distance; USD 85 000 - 100 000; Plein temps

Avantages offerts par ce poste

Remote work environment

401(k) employer match

Comprehensive health benefits

Educational assistance

Generous vacation policy

Résumé du poste

Gainwell Technologies is seeking a Medical Reviewer (Physical Therapist) to provide clinical expertise supporting California Medical Review Services. You will review therapy-related records, claims, TARs, treatment plans, and supporting docs to ensure services meet clinical, coverage, and program requirements.

The role emphasizes strong clinical judgment, independent work from a home office, and collaboration with physicians, nurses, therapists, and operations teams.

Qualifications

• Three (3) years of experience as a Physical Therapist.
• California license to practice Physical Therapy or eligibility for licensure.
• Current professional certification in good standing.

Responsabilités

• Review PT-related medical records, claims, TARs, treatment plans, and supporting documentation.
• Evaluate requested therapy services based on clinical documentation and policy requirements.
• Apply PT principles and clinical judgment to support medical necessity determinations.
• Review treatment plans and documentation for requested services.
• Document findings and rationale accurately and timely.
• Refer complex cases to appropriate medical professionals when needed.
• Collaborate with physicians, nurses, therapists, and other teams to resolve questions.
• Maintain knowledge of PT standards, policies, and regulatory guidelines.

Connaissances

Clinical judgement

Written communication

Verbal communication

Independent work

Cross-functional collaboration

Formation

Accredited Physical Therapy program

Description du poste

Gainwell Technologies is seeking a Medical Reviewer (Physical Therapist) to provide clinical expertise supporting California Medical Review Services. You will review therapy-related records, claims, TARs, treatment plans, and supporting docs to ensure services meet clinical, coverage, and program requirements.

The role emphasizes strong clinical judgment, independent work from a home office, and collaboration with physicians, nurses, therapists, and operations teams.