Physical Therapist - Utilization Review

Job Description

Job Description

Physical Therapist – Utilization Review

Required : Current, active, and unrestricted Physical Therapy license issued by the Arkansas State Board of Physical Therapy.

Job Summary

Astyra is seeking a licensed Physical Therapist (PT) to join our Utilization Review and Management team. The PT will apply clinical judgment and critical thinking to evaluate medical necessity and treatment appropriateness for physical therapy and rehabilitative services. This position requires accurate abstraction and documentation of review data to support utilization determinations.

Responsibilities

• Review and analyze medical records to determine the medical necessity and appropriateness of physical therapy and rehabilitative services.
• Abstract and document review data accurately and timely, summarizing key findings and justifications in accordance with company and client standards.
• Compare clinical documentation to utilization criteria and evidence-based guidelines to ensure appropriate care and resource use.
• Issue approvals or initiate referrals to consulting physicians as needed, providing a clear rationale for determinations.
• Ensure quality, accuracy, and compliance with productivity, QA, and contractual benchmarks.
• Collaborate with internal and external stakeholders to maintain open communication and consistent case handling.
• Contribute to process improvement initiatives and ongoing reassessment of review procedures.
• Maintain confidentiality and compliance with HIPAA policies at all times.
• Participate in cross-training to enhance team flexibility and coverage.

Experience & Qualifications

Attention Applicants : Please be advised that proper email communication will only be sent from email addresses ending in @astyra.com. Please ensure you are communicating with approved Astyra recruiters by checking this point when receiving offers and messages from us. It is important to communicate within our guidelines and proper channels to expedite possible interview considerations.

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