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Therapy Clinical Reviewer Jobs (NOW HIRING)

Medata Inc.

$80K - $90K/yr

They also provide tele-services, such as physical therapy consultation calls, to patients remotely ... Clinical Review * Initiates review for requested service upon system referral (or referral from non ...

Comagine

Clinical Reviewer

Master's in physical or occupational therapy OR Master's in psychology, counseling, or social work ... Clinical documentation review expertise, including use of the Oregon Health Plan Prioritized List ...

Cohere Health

Clinical Reviewer, DPT

$95K - $105K/yr

Clinical Reviewer, DPT United States Opportunity Overview ... We are looking for a Doctor of Physical Therapy (DPT) who has expertise in Physical Therapy to ...

Comagine

Clinical Reviewer (PT or OT-Licensed)

$60K - $81K/yr

Comagine Health is seeking remote Clinical Reviewers (Licensed Physical Therapist or Occupational Therapist) to support workers' compensation reviews, with one full-time opening and one PRN/part-time ...

Comagine Health

$91K - $119K/yr

Clinical Reviewers work from an electronic review queue to evaluate therapy authorization requests and supporting medical records for medical necessity and appropriateness. They apply workers ...

Self Medical Group

$47K - $66K/yr

Therapy Clinical Service Manager - Outpatient Job Category : Professional Requisition Number ... For further information, please review the Know Your Rights notice from the Department of Labor. #J ...

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Therapy Clinical Reviewer information

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$14

$34

$90

How much do therapy clinical reviewer jobs pay per hour?

As of Sep 15, 2026, the average hourly pay for therapy clinical reviewer in the United States is $34.62, according to ZipRecruiter salary data. Most workers in this role earn between $16.59 and $32.93 per hour, depending on experience, location, and employer.

What is a therapy clinical reviewer?

A Therapy Clinical Reviewer is a licensed health professional, such as a physical therapist, occupational therapist, or speech-language pathologist, who evaluates clinical documentation and treatment plans to determine the medical necessity and appropriateness of therapy services. They typically work for insurance companies, healthcare organizations, or third-party review agencies, and ensure that therapy services provided to patients meet established guidelines and standards of care. Their work helps promote quality patient care while managing healthcare costs and complying with regulations.

What does a therapy clinical reviewer do?

As a therapy clinical reviewer, your job is to review each case and determine whether or not a proposed care plan is appropriate for the patient. In this role, you may gather and document information about the patient and their case, review their eligibility for insurance benefits, and make the final decision about whether a particular service or treatment should be used. A therapy clinical reviewer often specializes in specific areas, such as physical therapy or speech therapy, and may focus on unusual or expensive cases that require extra attention during the auditing process. You may also coach letter writers to ensure that the appropriate medical necessity language is used in denial letters.

What are the key skills and qualifications needed to thrive as a therapy clinical reviewer?

To thrive as a Therapy Clinical Reviewer, you need a solid background in behavioral health or therapy, typically supported by a relevant clinical license (e.g., LCSW, LPC, or LMFT) and experience in direct patient care. Familiarity with utilization management software, electronic health records (EHRs), and knowledge of insurance or regulatory guidelines are commonly required. Strong analytical skills, attention to detail, and effective communication are essential soft skills for evaluating clinical documentation and collaborating with providers. These skills and qualifications ensure accurate clinical reviews, regulatory compliance, and optimal patient outcomes.

What are the primary responsibilities of a therapy clinical reviewer and how do they interact with other healthcare professionals?

A Therapy Clinical Reviewer is responsible for evaluating therapy-related clinical documentation to determine the medical necessity and appropriateness of proposed treatments. This role often involves reviewing patient records, treatment plans, and progress notes submitted by therapists, and making recommendations or decisions regarding coverage or further care. Therapy Clinical Reviewers frequently collaborate with therapists, physicians, and case managers to clarify clinical details and ensure adherence to policy guidelines. Effective communication and teamwork are essential, as the reviewer must translate clinical findings into actionable feedback and sometimes participate in multidisciplinary case discussions.
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Therapy Clinical Reviewer jobs near you
Infographic showing various Therapy Clinical Reviewer job openings in the United States as of September 2026, with employment types broken down into 3% As Needed, 73% Full Time, 16% Part Time, and 8% Contract. Highlights an 84% Physical, 1% Hybrid, and 15% Remote job distribution, with an average salary of $72,002 per year, or $34.6 per hour.

Clinical Reviewer

On-site

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

$80K - $90K/yr

Other

Posted 11 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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