Clinical Compliance Reviewer

Ensuring clinical documentation meets payer-specific insurance coverage criteria, the full-time Clinical Compliance Reviewer will perform detailed evaluations of Speech-Language Pathology reports and collaborate with funding teams to streamline the funding process in a remote setting. Key responsibilities Conduct comprehensive reviews of SLP evaluation reports to ensure alignment with payer coverage criteria Support the funding workflow by ensuring documentation is audit-ready and compliant prior to submission Provide actionable feedback to SLPs to enhance report quality and compliance with payer expectations Required qualifications Bachelor's Degree and/or 3-5 years of healthcare or clinical-related experience Knowledge of DME Billing and Prior Authorizations Technical writing skills Intermediate proficiency in Microsoft Word and Excel Familiarity with Medicare, Medicaid, and Commercial Insurance