Clinical Nurse Informaticist
Columbus, OH · On-site
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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.