Occupational Therapist Reviewer

Company Overview

Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact.

Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company; to actively engage in problem-solving; and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes – making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector.

Acentra Health is looking for a Clinical Reviewer to join our growing team.

Job Summary:

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, make informed approval decisions, or coordinate referrals to consulting physicians, and ensure accurate, timely documentation of review outcomes. 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.

This position plays a key role in supporting high-quality healthcare decisions while maintaining compliance with HIPAA regulations, contract requirements, and organizational standards.

Responsibilities:

• 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 thecorrespondence.
• 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.
• Performs 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.

• 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

• 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…