Clinical Review Specialist - Military veterans preferred

Genex Service LLC


Clinical Review Specialist

US--Remote

Job ID: 25-18088
Type: Regular Full-Time
# of Openings: 1
Category: Product & Program Management
Mitchell International, Inc.

Overview

At Enlyte, we combine innovative technology, clinical expertise, and human compassion to help people recover after workplace injuries or auto accidents. We support their journey back to health and wellness through our industry-leading solutions and services. Whether you're supporting a Fortune 500 client or a local business, developing cutting-edge technology, or providing clinical services you'll work alongside dedicated professionals who share your commitment to excellence and make a meaningful impact. Join us in fueling our mission to protect dreams and restore lives, while building your career in an environment that values collaboration, innovation, and personal growth.

Be part of a team that makes a real difference.

The Clinical Review Specialist is a vital member of the Clinical Oversight Team within Apricus. This role involves reviewing physical therapy services for injured workers to ensure high-quality care and appropriate treatment. You will provide clients with updated clinical summaries and recommendations regarding continuation or discontinuation of therapy services. This position is available as a remote work opportunity with expectations for maintaining confidentiality of company and customer information.

Key Responsibilities:

• Conduct reviews of physical or occupational therapy evaluation and treatment documentation
• Perform Peer-to-Peer communication with treating or supervising PTs and OTs via phone and/or email to review therapy care plans for injured workers covered by Workers Compensation claims.
• Utilize state and national disability guidelines to assess duration of care and provide clinical recommendations for ongoing therapy or discharge readiness. 
• Prepare detailed reports and clinical summaries with written support of recommendations for clients
• Maintain communication with nurse case managers and other claim stakeholders as needed
• Collaborate with operations and clinical admin staff to ensure appropriate authorization
• Perform provider follow up regarding authorization and/or clinical recommendations

Required Qualifications

• Degree in Physical Therapy with active license as Physical Therapist or Physical Therapist Assistant in the United States.
• Experience 3+ years  in outpatient therapy setting
• Exceptional communication skills, both written and verbal.
• Ability to provide comprehensive review reports for clients
• Demonstrate ability to meet metrics for reviews case load
• Excellent organizational skills with ability to prioritize work effectively
• Proficiency with company software and equipment

Preferred Qualifications:

• Experience in Workers Compensation Industry
• Knowledge of industry standard treatment guidelines
• Experience in performing quality assessments and/or clinical chart reviews

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