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Artech Information Systems LLC
360 Mt. Kemble Avenue, Suite 2000
Morristown, NJ, United States
Prior Authorization Therapist
Austin, TX, United States
$40.73 per hour
Physical Therapist / Occupational Therapist / Speech Therapist
Must meet Texas State licensure requirements for practicing in related field(s) and possess current and unrestricted PT, OT, or ST license from the State of Texas.
Minimum of two (2) years post licensure experience in area of licensure in a hospital, clinic or agency. icensed Conducts pre-service, concurrent/continued stay, retrospective, out of network and appropriateness of treatment setting reviews to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits, and contracts.
Service requests may be from electronic transmission, inbound calls and facsimile.
Outbound calls to the provider may be required to gather additional information that may be needed.
Conducts review activities which require the review of clinical information against client specific criteria, but excludes denial determinations.
Ensures member access to medical necessary, quality healthcare in a cost effective setting according to contract.
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