Therapy Services Reviewer

Elevance Health • Indianapolis, IN • 2h ago

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), providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law.

How you will make an impact:

· Follows the system guidelines that makes 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 timeframes.

Minimum Requirements:

· Requires 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, which would provide an equivalent background.

· Current active unrestricted license or certification as a physical therapist assistant, occupational therapist assistant, or speech language pathologist assistant in applicable state required. Certification and/or licensure appropriate to field of specialty is required.

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration (https://info.flclearinghouse.com/) .

Similar Jobs

SAP O2C Settlement Management Lead (Techno/Functional)

TEKsystems • Indianapolis, IN • 5h ago

Hospital & Medical

W2 ONLY, NO C2C HYBRID in Indianapolis, Indiana (2-3 days onsite, the rest remote) Top Skills' Details: 7-10 years of experience with SAP O2C. Experience in Settlement Management. I'm ok to take a risk on someone with le...

5h ago

Go to Apply

SAP GTS (Global Trade Services) Lead (Techno/Functional)

TEKsystems • Indianapolis, IN • 5h ago

Hospital & Medical

W2 ONLY, No C2C Hybrid Schedule ONSITE in Indianapolis, IN (2-3 days onsite/the rest remote) SAP GTS (Global Trade Services) Lead (Techno/Functional) Top Skills: -Systems in scope: GTS, SAP SD -Projects: we're currently...

5h ago

Go to Apply

Maintenance Technician I - O'Neal Manufacturing Services

O'Neal Industries, Inc. • Indianapolis, IN • 10h ago

Hospital & Medical

Description Build A Career That's Made to Last. O'Neal Manufacturing Services is one of the largest family-owned metal fabrication companies in the United States. For over 100 years, we've built more than just metal - we...

10h ago

Go to Apply

Regional Vice President II (RVP) of Provider Solutions (Healthcare Networks)

Elevance Health • Indianapolis, IN • 18h ago

Hospital & Medical

Regional Vice President II (RVP) of Provider Solutions (Healthcare Networks) Location: Indianapolis, Indiana This role requires associates to be in-office at least 3 days per week, fostering collaboration and connectivit...

18h ago

Go to Apply

Technology Strategy Principal Director, Life Sciences Industry

Accenture • Carmel, IN • 23h ago

Hospital & Medical

Technology Strategy Principal Director -- Life Sciences Industry We Are: Technology Strategy and Advisory and we design and execute industry-relevant reinventions that allow organizations to realize exceptional business...

23h ago

Go to Apply

Registered Nurse - PRN Homecare

Maxim Healthcare • Avon, IN • 1d ago

Hospital & Medical

Hourly Pay: $45 - $50 / per hour Maxim Healthcare in Indianapolis is hiring for a Registered Nurse to work with Pediatric and/or Adult patients in their own homes. Why Join Maxim: Competitive Pay & Weekly Paychecks H...

1d ago

Go to Apply

LPN - PRN Homecare

Maxim Healthcare • Avon, IN • 1d ago

Hospital & Medical

Hourly Pay: $35 - $40 / per hour Maxim Healthcare in Indianapolis is hiring for a Licensed Practical Nurse (LPN) to work with Pediatric and/or Adult patients in their own homes. Why Join Maxim: Competitive Pay & Week...

1d ago

Go to Apply

LPN - Evening Shift

Maxim Healthcare • Indianapolis, IN • 2d ago

Hospital & Medical

Hourly Pay: $35 - $40 / per hour Schedule: 8:30pm - 11:30pm / Saturday and Sunday Maxim Healthcare in Indianapolis is hiring for a Licensed Practical Nurse (LPN) to work with Pediatric and/or Adult patients in their own...

2d ago

Go to Apply

Optometrist

America's Best • Plainfield, IN • 2d ago

Hospital & Medical

Love What You Do - And Where You Do It We're reimagining what a career in optometry should look like. Think less burnout, more balance. Less micromanagement, more autonomy. Less routine, more purpose! At our practice, yo...

2d ago

Go to Apply

(USA) Shipping and Receiving Coordinator, Central Fill, Health and Wellness Central Operations - Health and Wellness

Walmart • Plainfield, IN • 2d ago

Hospital & Medical

Position Summary... What you'll do... Maintains sorter operation by removing full totes from the sorter tote location replenishing empty totes at the sorter locations scanning tote and location with a handheld scanner an...

2d ago

Go to Apply

Subscribe to get new jobs sent directly to you
(no charge, cancel anytime)