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Remote Physical Therapy Utilization Review Jobs in Florida

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Remote Physical Therapy Utilization Review information

What is a remote physical therapy utilization review?

A Remote Physical Therapy Utilization Review job involves evaluating physical therapy treatment plans and medical records to ensure they meet insurance guidelines and medical necessity. Professionals in this role work remotely to review claims, provide recommendations, and collaborate with healthcare providers and insurance companies. The goal is to ensure appropriate care while preventing unnecessary treatments or costs. This position typically requires a background in physical therapy, strong analytical skills, and knowledge of insurance policies and medical guidelines.

What does a typical day look like for someone in a remote physical therapy utilization review role?

A typical day involves reviewing physical therapy documentation and treatment plans submitted by providers to determine if they meet established medical necessity criteria. You may spend most of your workday analyzing patient records, applying evidence-based guidelines, documenting your recommendations, and collaborating virtually with providers, insurance representatives, and your clinical review team. Frequent video meetings and written communications are common as you clarify treatment justifications or support appeals. The role is fast-paced and detail-oriented, requiring strong organizational skills to manage multiple case files and deadlines efficiently. While remote, you remain an integral part of a clinical decision-making team, contributing directly to patient care quality and cost-effective service delivery.

What are the key skills and qualifications needed to thrive in the remote physical therapy utilization review position?

To excel as a Remote Physical Therapy Utilization Review professional, you need a background in physical therapy (often with licensure), clinical knowledge, and experience in utilization management or case review. Familiarity with electronic health records (EHR), claims management systems, and industry tools such as InterQual or Milliman criteria is typically required. Strong analytical skills, attention to detail, effective written communication, and the ability to work independently are valuable soft skills for this position. These abilities are crucial for accurately evaluating medical necessity, facilitating reimbursement, and ensuring compliance with healthcare guidelines in a remote setting.

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Cities in Florida with the most Remote Physical Therapy Utilization Review job openings:

Remote Physical Therapy Utilization Review jobs near you
Infographic showing various Remote Physical Therapy Utilization Review job openings in Florida as of August 2026, with employment types broken down into 1% As Needed, 79% Full Time, 16% Part Time, 1% Temporary, 2% Contract, and 1% Nights. Highlights an 97% Physical, 1% Hybrid, and 2% Remote job distribution.

Utilization Review Coordinator

NRG MGMT LLC

Lake Worth, FL • Remote

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 13 days ago

Job description

Remedial Pro is a specialized medical billing company serving substance abuse treatment and behavioral health providers. Through services including benefits verification, billing and claims submission, and utilization review, we help treatment centers optimize revenue cycle management while focusing on delivering exceptional patient care. Our team is committed to accuracy, professionalism, efficiency, and outstanding client service

JOB DESCRIPTION

The primary goal is to monitor adherence to the facility’s utilization review plan to ensure the effective and efficient use of facility services and monitor the appropriateness of facility  admissions and extended facility stays.

Job Classification: Non Exempt Hourly        Reports To: Senior RCM Director

Supervisory Responsibilities:   None.

JOB DUTIES:

  • Completes Initial, concurrent, peer reviews, and expedited appeals in a timely manner to ensure continuous coverage.
  • responsible for all aspects of the authorization of treatment via insurance and managed care companies.
  • Utilize clinical information and knowledge of Medical Necessity criteria to effectively communicate plans of care to insurance case managers, facility staff, and healthcare partners.
  • Collaborate with facilities in order to obtain necessary clinical documentation for reviews and ensure appropriate lengths of stay and effective utilization of resources.
  • Represents the company in a positive manner per the Professional Standards of Conduct
  • Protects the confidentiality of patients and the privacy of staff
  • provides appropriate client information to third party payers regarding the medical necessity of treatment in a timely manner.
  • Uses a computer to type correspondence, reports and other items as requested,
  • Experience in the Mental Health/Addiction space, May be a fully licensed SUDC, CAC,LADC, LCSW, CMHC or RN
  • Additional duties as assigned.

MINIMUM QUALIFICATIONS

  • Bachelor’s or Master’s degree in Behavioral/Mental Health Field (or related experience) preferred
  • A minimum of 3-5 years experience doing utilization review is required preferred
  • Expertise in psychiatric and addiction disorders
  • Experience interacting effectively with co-workers as well as clients.
  • Experience maintaining confidentiality in accordance with HIPAA and company policy requirements.

Required Skills/Abilities:

  • Excellent verbal and written communication skills.
  • Excellent organizational skills and attention to detail.
  • Excellent time management skills with a proven ability to meet deadlines.
  • Proficient with Microsoft Office Suite or related software.
PHYSICAL REQUIREMENTS
  • Prolonged periods sitting at a desk and working on a computer.

Remote Position

Benefits:

• Competitive salary

• Health, dental, and vision insurance

• 401(k) with company match

• Paid time off and holidays

• Continuing education and professional development opportunities

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