Licensed Clinical Claims Review Physical Therapist PT - Remote

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Written by AI from the job title and company, not by UnitedHealth Group, so some details may not match this job. The employer's own page has the real description.

Job Overview

The Licensed Clinical Claims Review Physical Therapist (PT) - Remote at UnitedHealth Group will be responsible for reviewing and evaluating claims related to physical therapy services. This position requires a detailed understanding of physical therapy protocols, effective communication skills, and a commitment to ensuring that claims are processed efficiently and accurately. The role involves collaborating with various stakeholders including healthcare providers, insurance representatives, and other clinical staff to ensure that all claims adequately reflect the patient's care and meets policy guidelines.

Job Responsibilities

• Evaluate and review claims submitted for physical therapy services for accuracy and compliance with insurance policies.
• Analyze clinical documentation to ensure thoroughness and adherence to established guidelines.
• Collaborate with healthcare providers to clarify any discrepancies in claims documentation.
• Provide feedback and recommendations for claims adjustments to ensure proper reimbursement.
• Utilize clinical expertise to inform decisions on claims and assist in staff training as needed.
• Stay updated on industry standards, regulations, and changes in reimbursement policies.
• Document all findings, communications, and decisions taken during the claims review process.

Qualifications

• Active and unrestricted Physical Therapy license.
• Minimum of three (3) years of clinical experience in physical therapy.
• Experience with claims processing and knowledge of insurance policies related to physical therapy services.
• Strong analytical skills with attention to detail.
• Excellent communication skills, both written and verbal.
• Proficiency in using electronic health records (EHR) and other relevant software.
• Ability to work independently with minimal supervision.

Technologies & Tools

The ideal candidate will be proficient in electronic health record (EHR) systems, claims management software, and various clinical documentation tools. Familiarity with telehealth platforms and other digital communication tools is also advantageous to facilitate collaboration with healthcare providers and the relevant stakeholders.

Ideal Candidates

Ideal candidates for the Licensed Clinical Claims Review Physical Therapist position will possess a blend of clinical expertise and administrative proficiency. They should demonstrate strong critical thinking skills, with a passion for detail-oriented work. A collaborative spirit and ability to communicate clearly with various stakeholders—connecting clinical insights to claims processing—will make a candidate successful. Being adaptable to evolving insurance policies and maintaining a patient-centered focus throughout the claims review process are equally important traits for this role.