Medical Reviewer (Prosthetic and Orthotic Devices Specialist) - Remote CA (West

It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development. Summary Gainwell Technologies is seeking a Medical Reviewer (Prosthetic and Orthotic Devices Specialist) to provide subject-matter expertise supporting Medical Review Services for California healthcare programs. In this role, you will review prosthetic and orthotic device requests, claims, Treatment Authorization Requests (TARs), prescriptions, and supporting documentation to help ensure services and devices meet applicable coverage, medical necessity, and program requirements. Your role in our mission Review claims, Treatment Authorization Requests (TARs), prescriptions, and supporting documentation involving prosthetic and orthotic devices. Evaluate prosthetic and orthotic requests based on applicable coverage requirements, medical policies, and professional standards. Assess documentation supporting the medical need and appropriate use of prosthetic and orthotic devices. Provide subject-matter expertise related to prostheti