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Pt Ot Utilization Review Jobs (NOW HIRING)

DMOS

Front Office Coordinator PT/OT

Ankeny, IA · On-site

$15.75 - $20.50/hr

This is a 20-hour part-time opportunity working (Mon-Thurs 1pm-6pm) * Providing and obtaining ... For further information, please review the Know Your Rights notice from the Department of Labor.

TCC Health

Chautauqua PT/OT Physical Therapist

Dunkirk, NY · On-site

$75K - $85K/yr

Reviews physician's referral and patient's medical records to help determine diagnosis and physical therapy treatments as * Records prognosis, treatment, response, and progress in the patient's chart ...

Madera Community Hospital

Peer Review Nurse

Madera, CA · On-site

$18.50 - $23.75/hr

Will facilitate the peer review process and attend peer review meetings. Part Time Position with ... and utilization review. Requires proficiency in data abstraction, EHR systems, and critical ...

Madera Community Hospital

Peer Review Nurse

Madera, CA · On-site

$46 - $61.91/hr

Will facilitate the peer review process and attend peer review meetings. Part Time Position with ... and utilization review. Requires proficiency in data abstraction, EHR systems, and critical ...

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PT OT Utilization Review information

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How much do pt ot utilization review jobs pay per hour?

As of Jun 13, 2026, the average hourly pay for pt ot utilization review in the United States is $31.94, according to ZipRecruiter salary data. Most workers in this role earn between $22.36 and $40.62 per hour, depending on experience, location, and employer.

What are some common challenges faced by PT/OT Utilization Review professionals, and how can they be managed?

PT/OT Utilization Review professionals often encounter challenges such as balancing clinical judgment with payer guidelines, managing a high volume of case reviews, and navigating communication between providers and insurance companies. Staying current with evolving policies and maintaining strong documentation are key to overcoming these obstacles. Effective time management and proactive collaboration with both clinical teams and payers can help ensure timely and accurate reviews while supporting patient care decisions.

What is a PT OT Utilization Review?

A PT OT Utilization Review is a process where physical therapy (PT) and occupational therapy (OT) services are evaluated to ensure that they are medically necessary, appropriate, and efficient. Utilization review professionals review patient records, treatment plans, and clinical documentation to determine if the care provided meets established guidelines and standards. This role is often performed by licensed PTs or OTs working for insurance companies, healthcare providers, or third-party administrators. The main goal is to promote high-quality care while preventing unnecessary or excessive therapy services.

What Are Jobs in PT/OT Utilization Review?

PT/OT utilization review jobs involve nurses and clinical reviewers who review an occupational or physical therapy patient case documentation to determine if the services the patient received meet the qualifications for their insurance coverage. Your responsibilities as a PT/OT utilization review worker are to write letters to an insurance company about the services a physical or occupational therapist provided, review a patient’s medical records, monitor a patient’s progress with therapy, and continue contact with a patient’s insurance company, the patient, and the patient’s medical team to ensure proper coverage of services. These jobs can be both part-time and full-time.

What are the key skills and qualifications needed to thrive as a PT/OT Utilization Review Specialist, and why are they important?

To thrive as a PT/OT Utilization Review Specialist, you generally need a valid physical or occupational therapy license, strong clinical knowledge, and experience in rehabilitation settings. Familiarity with utilization review software, electronic health records (EHRs), and knowledge of insurance guidelines and medical necessity criteria are important technical qualifications. Excellent communication, critical thinking, and attention to detail are essential soft skills for collaborating with providers and payers. These competencies ensure accurate evaluations, compliance with regulations, and optimal patient outcomes while managing healthcare costs.

What is the difference between Pt Ot Utilization Review vs Pt Ot Case Management?

AspectPt Ot Utilization ReviewPt Ot Case Management
CredentialsLicensed Occupational Therapist (OT)Licensed Occupational Therapist (OT) with case management training
Work EnvironmentInsurance companies, healthcare facilities, or third-party review organizationsHospitals, clinics, insurance companies, or outpatient settings
Primary FocusAssessing medical necessity and approving treatment plansCoordinating patient care, advocating for patients, and managing treatment progress

While both roles involve occupational therapy expertise, Pt Ot Utilization Review primarily focuses on evaluating the necessity of services, whereas Pt Ot Case Management emphasizes coordinating ongoing patient care and support. Understanding these differences helps clarify career paths and job expectations in the occupational therapy field.

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PT OT Utilization Review jobs near you
Clinical Documentation Specialist within PT/OT/SPT

Clinical Documentation Specialist within PT/OT/SPT

University of California San Francisco

San Francisco, CA • On-site

Full-time, Part-time

Posted 18 days ago

Job description

Job Description
Involves the evaluation of physician documentation, utilizing clinical expertise to ensure that the patient's severity of illness and risk of mortality are accurately portrayed in the medical record for specificity and increased coding accuracy. Interacts with physicians, clinical staff, and health information management professionals. Works with coding staff to ensure that documentation of discharge diagnoses and any coexisting co-morbidities are a complete reflection of the patient's clinical status and care. Involves education and training to physicians and clinical staff (nurses and therapists) as part of the onboarding and as rules and regulations change in the IRF level of care. The final salary and offer components are subject to additional approvals based on UC policy.
Qualifications
Required Qualifications :
  • Bachelor's degree in PT, OT or Master in SLP or related area, and / or equivalent combination of experience / training
    California License on respective fields (PT, OT, SLP or RN)
  • Min 2 years Clinical experience post-grad in a hospital setting.
  • Working knowledge and experience with the clinical and operational issues involved with inpatient care, including the diagnoses, treatments, medical procedures, case management, discharge, and other practices that are part of effective clinical care systems.
  • Detail oriented, with demonstrated ability to effectively manage time, see tasks through to completion, organize competing priorities, and effectively address complex, urgent issues as they arise.
  • Demonstrated critical-thinking and problem-solving skills to manage multiple levels of information and responsibilities, and quickly assess problems to develop multiple potential solutions.
  • Demonstrated interpersonal and educational skills, with the ability to collaborate effectively with clinical-care professionals, and to serve as an educational resource on coding, reimbursement, and other clinical documentation issues.
  • Demonstrated ability to interpret and effectively explain clinical and technical information both verbally and in writing, and to contribute to presentations, reports, and analyses as assigned.
  • Demonstrated ability to work with senior staff and managers and to provide recommendations on issues of functionality, clinical quality, and efficiency.
  • Demonstrated computer proficiency in relevant multiple technology applications.
  • Has flexibility to work across the system

Preferred Qualifications :
  • Working knowledge of the concepts, principles, practices, and regulatory requirements of accurate clinical documentation and medical record review, including SOI, ROM, HIMS, ICD-10 coding, DRG systems, standards of compliance, relevant Medicare Part A and Part B guidelines and other reimbursement processes.
  • Working knowledge of data collection, analysis, reporting techniques and systems, and of health care information management systems related to clinical care, documentation, reporting, and reimbursement.
  • PT

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