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Speech Therapist Reviewer Sr D...

Monster
 
 
 
 

Job Summary

Company
Anthem
Location
Houston, TX
Industries
Other/Not Classified
Job Type
Full Time
Employee
Career Level
Experienced (Non-Manager)
Job Reference Code
4298_PS2867

Speech Therapist Reviewer Sr Dallas or Houston, Texas PS2867

About the Job

Description
Your Talent. Our Vision. At Amerigroup, a proud member of the Anthem, Inc. family of companies focused on serving Medicaid, Medicare and uninsured individuals, it's a powerful combination. It's the foundation upon which we're creating greater care for our members, greater value for our customers and greater health for our communities. Join us and together we will drive the future of health care.
This is an exceptional opportunity to do innovative work that means more to you and those we serve.

This position is responsible for the review of medical records, including more complex cases, to determine if requests for therapy services (physical therapy, occupational therapy, and/or speech-language pathology) are medically necessary and filed appropriately. Primary duties may include, but are not limited to:

  • Applies professional therapy, government regulation and medical policy knowledge to medical review, and makes determinations for authorization requests, meeting all contract requirements, processes and operational unit goals to ensure customer satisfaction.
  • Maintains knowledge of regulations and requirements through review of current regulations and/or policies.
  • 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. Participates in or leads intradepartmental teams, projects and initiatives.
  • Maintains quality and productivity standards, and ensures reviews are conducted within required timeframe
Qualifications

Requirements

  • graduate of a college level program in physical therapy, occupational therapy, or speech language pathology;
  • 3 years of clinical experience; or any combination of education and experience, which would provide an equivalent background. Preferred years of experience is 10 years.
  • Current active unrestricted license as a physical therapist, occupational therapist, or speech language pathologist in applicable state required. Licensure appropriate to field of specialty as required.
  • This posting is for a Speech Therapist and will need a current active unrestricted license as a Speech Therapist
  • Pediatric experience preferred
  • Home Health Care experience preferred
  • Microsoft Office knowledge

Person in this position must work in our Grand Prairie or Houston. Remote work will be considered after 90 days. This is a Monday-Friday 8 AM- 5 PM role.

 

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