[Hiring] Occupational Therapist Reviewer @Acentra Health, LLC

Role Description

Acentra Health is looking for a Clinical Reviewer to join our growing team. We are seeking a detail-oriented clinician to review medical records and determine whether healthcare services meet established medical necessity and appropriateness criteria. In this role, you will:

• Analyze patient documentation and make informed approval decisions.
• Coordinate referrals to consulting physicians.
• Ensure accurate, timely documentation of review outcomes.
• Support high-quality healthcare decisions while maintaining compliance with HIPAA regulations, contract requirements, and organizational standards.

The ideal candidate is a self-motivated team player with strong critical-thinking skills, a commitment to quality and confidentiality, and the ability to build positive relationships with clients, providers, and internal stakeholders.

Responsibilities include:

• Review and interpret patient records and compare against criteria to determine medical necessity and appropriateness of care.
• Determine if the medical record documentation supports the need for services and documents appropriate interventions.
• Determine approval or initiate a referral to the consulting physician, and process the physician's decisions, ensuring that the reason for the denial is described in sufficient detail in the correspondence.
• Abstract review-related data/information accurately and timely.
• Foster positive and professional relationships and act as a liaison with internal and external customers to ensure effective working relationships and team building.
• Perform ongoing reassessment of the review process to offer opportunities for improvement and/or change.
• Always maintain the confidentiality of medical records and adhere to HIPAA policies.
• Actively cross-train to perform duties within the contract to provide a flexible workforce to meet client/consumer needs.
• Must be self-motivated, a team player, and energetic about meeting personal and professional goals.
• Read, understand, and adhere to all corporate policies, including policies related to HIPAA and its Privacy and Security Rules.

Qualifications

• Master’s or higher-level degree program in Occupational Therapist (OT).
• Current, active, and unrestricted license in the state of Arkansas as an Occupational Therapist (OT) issued by the Arkansas State Medical Board.
• 2+ years of clinical experience in an OT setting.
• 1+ years of experience supporting individuals with developmental disabilities.
• Must reside in the state of Arkansas.

Requirements

• Strong medical record abstracting skills and thorough knowledge of medical records.
• Excellent written and verbal communication skills.
• Strong clinical assessment and critical thinking skills.
• Thrive in a fast-paced environment with a focus on high productivity and efficiency.
• Demonstrated ability to collaborate effectively and adapt swiftly to changing circumstances.
• Strong organizational capabilities and proficiency in Microsoft Office Suite.
• Proven commitment to achieving both personal and professional development goals.

Benefits

• Comprehensive health plans.
• Paid time off.
• Retirement savings.
• Corporate wellness.
• Educational assistance.
• Corporate discounts.
• And more.

Compensation

The pay range for this position is listed below:

$28.00 to $38.00 per hour. Based on our compensation philosophy, an applicant’s position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level.