Physical Therapist​/Occupational Therapist; Therapy Services Reviewer

Overview

The Therapy Services Reviewer is responsible for the review of medical records to determine if requests for therapy services (physical therapy, occupational therapy) were medically necessary and filed appropriately.

Location:

Virtual. This role enables associates to work virtually full-time, with the exception of required in-person training sessions (when indicated). Per policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location will not be considered for employment unless accommodation is granted as required by law.

• Follows the system guidelines that make decisions on approval for care for a patient.
• Processes system generated decisions for authorization requests, meeting all contract requirements, processes, and operational unit goals to ensure customer satisfaction.
• Documents findings, develops analyses, and submits reports to the appropriate departments in accordance with government regulations and requirements.
• Researches and obtains additional data, consults with clinical reviewers and medical directors when necessary.
• Acts as a resource for internal and external customers.
• May participate in intradepartmental teams, projects, and initiatives.
• Maintains quality and productivity standards and ensures reviews are conducted within required time frames.

• Graduate of a college level program in physical therapy, occupational therapy, or speech language pathology or an accredited two-year program for a Physical Therapist Assistant, Occupational Therapist Assistant, or Speech Language Pathologist Assistant and minimum of 1 year of clinical experience; or any combination of education and experience that provides an equivalent background.
• Current active unrestricted license or certification as a physical therapist assistant, occupational therapist assistant, or speech language pathologist assistant in the applicable state required. Certification and/or licensure appropriate to field of specialty is required.

Physical Therapist or Occupational Therapist

Salary range for this position (for candidates working in person or virtually in the locations listed below): $32.60 - $40.78. Locations:
Illinois.

In addition to salary, Elevance Health offers benefits including a comprehensive package, incentive and recognition programs, equity stock purchase and 401k contribution (eligibility applies). The salary offered is based on legitimate, non-discriminatory factors and may be modified in the future. Equal pay opportunities are provided for equal work regardless of gender, race, or any other category protected by law.

The salary range is Elevance Health’s good faith estimate of possible compensation at the time of posting. Actual compensation may vary based on location, experience, education, and skill level. Details regarding bonuses, commissions, benefits, or other compensation are at the company’s discretion unless mandated by law.

Note:

Elevance Health only accepts resumes for compensation from agencies with a signed agreement. Unsolicited resumes submitted to hiring managers are the property of Elevance Health.

Elevance Health is a health company dedicated to improving lives and communities. We are a Fortune 25 company focused on making healthcare simpler and empowering leaders at all levels who are passionate about impacting our members and communities.

We are cultivating a culture that supports strategy, personal, and professional growth. We offer market-competitive total rewards including merit increases, paid holidays, paid time off, incentive programs, medical/dental/vision coverage, disability benefits, 401(k) + match, stock purchase plan, life insurance, wellness programs, and financial education resources. Hybrid workforce expectations vary by role; time onsite will be discussed during the hiring process.

All new candidates in certain patient/member-facing roles may be required to be vaccinated against COVID-19 and Influenza; offers may be rescinded if not compliant unless an acceptable exemption is provided. Elevance Health complies with applicable laws.

Elevance Health is an Equal Employment Opportunity employer. Qualified applicants will be considered without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status protected by law. Applicants needing accommodation to participate in the job application process may contact elevancehealthj for assistance.

Qualified applicants with arrest or conviction records will be considered in accordance with the Fair Chance Act and related laws.