Medical / Clinical Reviewer - Physical / Speech Therapist

Responsibilities

• Conduct comprehensive pre-billing audits on patient records to verify that services are documented accurately and align with insurance guidelines.
• Ensure all therapy notes and coding are accurate, complete, and in compliance with insurance and regulatory standards.
• Work with clinician to identify and rectify discrepancies or errors in documentation and billing submissions.
• Provide feedback to clinicians and administrative staff regarding documentation improvements and compliance requirements.
• Stay updated on changes in insurance policies, billing codes, billing modifiers and regulatory requirements affecting therapy services.
• Collaborate with the billing department to resolve any issues related to claims denials or rejections.
• Prepare detailed reports on audit findings and recommend corrective actions as needed.
• Assist in developing and implementing internal policies and procedures related to billing and documentation standards.
• Bachelor's degree in physical therapy, speech therapy, occupational therapy, or a related field; relevant work experience may be considered in lieu of a degree.
• Previous experience in medical billing, coding, or auditing within a healthcare setting, preferably in therapy.
• Certification in medical billing and coding (e.g., CPC, CCS, or equivalent) is preferred.
• Strong knowledge of insurance billing practices, medical terminology, and regulatory standards in the US.
• Excellent analytical skills and attention to detail.
• Strong communication skills, with the ability to provide clear feedback and guidance to clinical and administrative staff.
• Proficiency in using electronic health record (EHR) systems and billing software.

Benefits

Additional Information

Job Title: Medical / Clinical Reviewer - Physical / Speech Therapist Location : Chennai, TN Positions Numbers: 8 Nos. Position Type: Full-Time / Part-Time Job Summary: The Medical Reviewer will be responsible for conducting pre-billing audits to ensure all documentation and billing submissions comply with insurance standards and regulatory requirements. This role is critical in safeguarding the financial integrity of the practice and ensuring timely reimbursement from insurance providers.

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Company Intel

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