Us
Clinical Compliance Reviewer
Remote US-PA
Sponsorship not specifiedDetected 23 days ago
ExpressExcelCommunicationCollaborationProblem SolvingTime ManagementWritingMicrosoft Office
About the role
- At Tobii Dynavox, you can grow your career within a dynamic, global company that has a clear, impactful purpose - with the flexibility to also do what truly matters to you outside of work.
- As a member of our team, you'll have the power to make it happen.
- Where we stand: We believe diversity not only enriches our workplace culture, but also gives us a strategic advantage.
Responsibilities
- In addition to conducting detailed reviews, the Clinical Compliance Reviewer actively supports initiatives to reduce the administrative and documentation burden on SLPs by improving report quality, clarity, and alignment with payer expectations.
- Identify gaps, inconsistencies, or risks that may lead to funding delays, denials, or requests for additional information.
- Funding Process Support
- Collaborate with funding teams to resolve clinical documentation issues and facilitate timely progression of cases through the funding pipeline.
- SLP Support & Documentation Optimization
- Contribute to the development and refinement of tools, templates, and resources designed to simplify the report writing and funding process.
- Partner with internal teams to identify trends in denials or documentation challenges and implement proactive solutions.
- Collaborate with policy and compliance teams to ensure clinical review processes remain aligned with evolving insurance requirements.
Requirements
- Utilize established criteria checklists to validate that all required components are present and meet payer expectations.
- Knowledge of DME Billing and Prior Authorizations
- Intermediate level skills in Microsoft Word & Excel with ability to learn additional systems as needed
Benefits
- Perform comprehensive reviews of SLP evaluation reports and related clinical documentation to ensure alignment with payer-specific coverage criteria and policies.
- Evaluate documentation for completeness, accuracy, and medical necessity in accordance with insurance requirements, including detailed clinical rationale and supporting evidence.
- Support the funding workflow by ensuring clinical documentation is audit-ready and aligned with insurance coverage requirements prior to submission.
- Support SLPs through direct communication, education, and one-on-one guidance to help them navigate documentation requirements and reduce revisions.
- Bachelor's Degree and/or 3-5 years healthcare/clinical-related experience
Equal opportunity
- Employer/AA Women/Minorities/Veterans/Disabled
- We believe diversity not only enriches our workplace culture, but also gives us a strategic advantage.
- Working with people from a variety of backgrounds and perspectives helps us all become better communicators, better problem solvers, and better human beings.
- Our differences make us stronger.
This listing is sourced directly from Us's careers page and normalized into a canonical job model.