Remote PT/OT Clinical Reviewer for Medical Utilization

Comagine Health; Northern (KY); Hybrid; USD 91,000 - 119,000; Full time

Benefits offered by this job

Medical, dental and vision insurance

Paid time off

Retirement savings plan with employer

Paid parental leave

Job summary

Comagine Health is seeking remoteClinical Reviewers (Licensed Physical Therapist or Occupational Therapist) to support workers’ compensation therapy reviews. Two openings: one full-time and one PRN/part-time. Remote work nationwide with an annual salary range of $91,000 to $119,000.

Requires licensure and 5 years of direct clinical experience; strong documentation and communication skills essential. Responsibilities include reviewing medical records, applying guidelines, preparing reports, and

Qualifications

• Masters degree in Physical Therapy or Occupational Therapy.
• Current, active, unrestricted PT or OT licensure in required state.
• 5 years of direct clinical patient care experience or ICU/ER experience.

Responsibilities

• Review clinical documentation to determine medical necessity and appropriateness of services.
• Perform prior authorization, concurrent and retrospective reviews using criteria and guidelines.
• Conduct level of care reviews when needed and consult with physicians when criteria are not met.
• Document review decisions and prepare denial summaries and recommendations.
• Validate or correct CPT coding and draft amended reports after physician consultations.
• Coordinate with clients, providers, and internal teams to share information.

Skills

Clinical review

Medical terminology

Decision making

Documentation

Education

Master's degree in Physical Therapy or Occupational Therapy

Active PT/OT license (unrestricted)

Tools

InterQual

ASAM

Milliman Criteria

MS Office Suite

Job description

Comagine Health is seeking remoteClinical Reviewers (Licensed Physical Therapist or Occupational Therapist) to support workers’ compensation therapy reviews. Two openings: one full-time and one PRN/part-time. Remote work nationwide with an annual salary range of $91,000 to $119,000.

Requires licensure and 5 years of direct clinical experience; strong documentation and communication skills essential. Responsibilities include reviewing medical records, applying guidelines, preparing reports, and