Medical Reviewer (Speech and Audiology Specialist)
G
Gainwell TechnologiesHealthcare
United StatesFull-TimeMiddle
Salary80,000 - 100,000 USD per year
Apply NowOpens the employer's application page
Job Details
- Experience
- Minimum of three (3) years of experience as a Speech, Language, or Audiology practitioner.
Requirements
- Minimum of three (3) years of experience as a Speech, Language, or Audiology practitioner.
- Current California professional credentials as applicable to the discipline.
- Current Certificate of Clinical Competence in Speech-Language Pathology or Audiology granted by the American Speech-Language-Hearing Association (ASHA).
- Strong clinical judgment and ability to interpret clinical records, treatment plans, and supporting documentation.
- Strong oral and written communication skills.
- Ability to work independently while collaborating effectively with clinical, operational, and cross-functional teams.
- Maintain all professional licenses, certifications, and credentials in active and good-standing status.
Responsibilities
- Review speech, language, and audiology-related claims, Treatment Authorization Requests (TARs), treatment plans, and clinical documentation.
- Evaluate requested services based on applicable medical policies, coverage requirements, and professional standards.
- Apply speech-language pathology or audiology expertise to support medical necessity and appropriateness determinations.
- Document review findings, decisions, and supporting clinical rationale accurately and timely.
- Refer cases requiring additional clinical review to appropriate medical professionals when needed.
- Collaborate with physicians, nurses, other clinical specialists, operations teams, and business partners to resolve review questions.
View Full Description & ApplyYou'll be redirected to the employer's site
