Therapist ReviewerNCMMIS is in search of 1 Therapist Reviewer.Labor Category – Therapist ReviewerTemp position (conversion to CSRA possible)Selection based upon candidate's ability to meet Basic Qualifications at the best value.Rate will need to be established on agreement prior to starting of approved candidate. If rate is not already established please inquire with SCA on NTE Program rate prior to submitting candidates/proposed rate.Job DescriptionAnalyzes durable medical equipment (DME) prior approval requests for NC Medicaid to ensure compliance with clinical guidelinesPerforms review of documentation submitted prior approval requests for DME services to determine if the recipient is eligible for the services being requestedContract Labor Category Description / RequirementsTherapist Reviewer - Performs reviews of prior approval requests submitted by enrolled providers. Escalates problems to appropriate personnel, as appropriate.
- Bachelor's degree or equivalent combination of education and experience - Two years allied health experienceRequired SkillsetRequires active NC license as Physical Therapist (in good standing)Ability to work independently to meet individual performance standardsMust be comfortable with using a computerKnowledge of Microsoft Office and OutlookPrefer to have knowledge of NC TracksPrefer to have knowledge of business processes of NC DHHS and/or NC Health ChoicePrefer experience with DME and pediatric physical therapy2 years physical therapy experienceActive NC License as Physical Therapist (in good standing)Work EnvironmentOffice environmentAdditional InformationPlace of Performance - 2610 Wycliff Rd, Raleigh, NCPeriod of Performance – Start date and ongoing (conversion to CSRA possible)