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Non Clinical Reviewers Jobs (NOW HIRING)

Medata Inc.

$80K - $90K/yr

Initiates review for requested service upon system referral (or referral from non-clinical staff) * Review types include Utilization Review and Continued Authorization (provide documented ...

Comagine Health

Clinical Reviewer DC

Washington, DC · On-site

Provide daily oversight and monitoring of non-clinical staff during their performance of non ... Review and understand treatment plans to substantiate clinical appropriateness of services to ...

Comagine

Clinical Reviewer DC

Washington, DC · On-site

Provide daily oversight and monitoring of non-clinical staff during their performance of non ... Review and understand treatment plans to substantiate clinical appropriateness of services to ...

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Infographic showing various Non Clinical Reviewers job openings in the United States as of August 2026, with employment types broken down into 3% As Needed, 74% Full Time, 15% Part Time, and 8% Contract. Highlights an 85% Physical, 1% Hybrid, and 14% Remote job distribution.

Clinical Reviewer

On-site

Medata Inc.
Software Development • 51 - 200 employees
Learn more about Medata Inc.external

$80K - $90K/yr

Other

Posted 8 days ago

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Clinical Reviewer- PT

Full Time Regular Professional US

3 days ago Requisition ID: 2806

Salary Range: $80,000.00 To $90,000.00 Annually

Job Summary

PT, DPT, MPT licensure required for Consideration

A Clinical Reviewer is responsible for reviewing medical records, patient information, and treatment plans to ensure compliance with clinical guidelines and standards. They also provide tele-services, such as physical therapy consultation calls, to patients remotely. This role requires strong clinical knowledge, excellent communication skills, and the ability to make informed decisions regarding patient care.

Primary Duties & Responsibilities
  • Clinical Review
    • Initiates review for requested service upon system referral (or referral from non-clinical staff)
      • Review types include Utilization Review and Continued Authorization (provide documented recommendations to adjusters and Nurse Case Managers based on use of appropriate guidelines.)
    • Reviews each case, and formulates recommendations through use of established medical criteria and clinical judgment and communicates case recommendations and potential appeal options as appropriate.
      • Reviews initial evaluation and all clinical documentation against APTA standards, applicable state regulations and relevant treatment guidelines.
      • If necessary, contacts the treating practitioner for additional information or clarification.
      • If necessary, consults with the Medical / Clinical Director or other licensed health professional in the same licensure category or with the same clinical education as the ordering provider.
    • As identified, conducts ongoing review(s) of active cases regarding the need for continued services or treatment
    • Submits supportive research relevant to peer review and best evidence practice patterns.
    • Documents all pertinent clinical patient / case file information and actions into case notes.
    • Appropriately refers cases for review by a physician, chiropractor, or other peer reviewer as required, providing case documentation and clinical recommendations.
    • Serves as a clinical resource and provides oversight of non-clinical personnel and identifies training needs and communicates to the appropriate supervisor / manager.
    • Complies with all established policies and procedures
    • Attends meetings and trainings.
    • Meets quality management standards.
    • Performs activities within the scope of professional licensure.
    • Completes other duties and projects as assigned.
  • Tele- services
    • Applies MedRisk's consultation program inclusion guidelines to assigned cases to determine eligibility and appropriateness.
    • Document telerehabilitation consultation in a manner consistent with company policies and department procedures.
    • Perform telephonic outreach to patient, in-clinic provider, payor and physician when needed, or as requested.
    • Document all communications with case stakeholders (adjusters, case managers, in-clinic providers.)
Qualifications
  • Must be an appropriate health professional and possess an active professional relevant license (PT, MPT, DPT)
  • Professional experience in providing direct patient care, strong outpatient and/or worker's compensation experience preferred (8 + years)
  • Experience with FCEs preferred but not required
  • Experience in utilization review, case management, quality improvement and/or managed care is desired
  • Excellent verbal and written communication skills
  • Organizational skills, prioritization, problem-solving and decision-making skills are required
  • Ability to multi-task in a fast paced environment
  • Must be computer literate and be able to use the keyboard accurately. Experience with Microsoft Office and review applications is desired
  • Strong analytical and interpersonal skills are also required
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