Clinical Review Specialist
Clinical Review Specialist
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Job Description
Job Title: Clinical Review Specialist
Company Overview:
Pulivarthi Group is a premier global provider of staffing and IT technology solutions renowned for delivering exceptional services tailored to each clients unique needs. With a steadfast commitment to excellence we merge expertise with innovation ensuring cost-effective solutions of the highest quality. Our diverse client base spans healthcare finance government and beyond reflecting our adaptability and proficiency across industries. Operating in the United States Canada and Mexico we pride ourselves on aligning with clients cultures deploying top-tier talent and utilizing cutting-edge technologies. Pulivarthi Group stands as a beacon of reliability efficiency and innovation in the realm of staffing solutions.
Job Overview/Summary:
We are seeking a Clinical Review Specialist with a background in physical therapy to perform clinical assessments and reviews of therapy documentation. This role supports Workers Compensation cases and involves communication with healthcare providers and case managers to ensure optimal treatment plans for injured workers.
Responsibilities:
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Conduct reviews of physical or occupational therapy evaluation and treatment documentation
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Perform peer-to-peer communication with treating or supervising PTs and OTs via phone and/or email to review therapy care plans
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Utilize state and national disability guidelines to assess duration of care and provide clinical recommendations
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Prepare detailed reports and clinical summaries with written support of recommendations for clients
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Maintain communication with nurse case managers and other claim stakeholders
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Collaborate with operations and clinical admin staff to ensure proper authorization processes
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Perform provider follow-up regarding authorization or clinical recommendations
Primary Skills:
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Clinical evaluation and review of therapy documentation
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Strong verbal and written communication
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Case documentation and reporting
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Familiarity with Workers Compensation treatment protocols
Secondary Skills (Good to Have):
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Understanding of industry-standard treatment guidelines
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Experience with quality assessments or clinical chart reviews
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Client communication and follow-up procedures
Qualifications:
Required Qualifications:
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Degree in Physical Therapy with active license as a Physical Therapist or Physical Therapist Assistant in the United States
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Minimum 3 years of experience in an outpatient therapy setting
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Excellent written and verbal communication skills
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Ability to produce comprehensive review reports
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Proven ability to meet metrics for case review volume
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Strong organizational and time management skills
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Proficiency with company software and systems
Preferred Qualifications:
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Experience in the Workers Compensation industry
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Knowledge of industry-standard treatment guidelines
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Background in performing quality assessments or clinical chart reviews
Benefits/Perks:
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Competitive compensation
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Remote work flexibility (if applicable)
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Opportunities for professional development
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Supportive team and collaborative work culture
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Access to industry training resources
Equal Opportunity Statement:
Pulivarthi Group is proud to be an equal opportunity employer. We are committed to building a diverse and inclusive culture and celebrate authenticity. We do not discriminate on the basis of race religion color national origin gender gender identity sexual orientation age marital status disability protected veteran status or any other legally protected characteristics.
Employment Type
Full Time
