Job Summary and Responsibilities The purpose of this position is to utilize clinical expertise, critical thinking, and decision‐making skills to review medical records against appropriate criteria in conjunction with contract requirements to determine medical appropriateness of Autism Spectrum Disorder Services, while maintaining production goals and QA standards. Location: Remote. Candidates must hold an active Indiana license (LBA) or be willing to apply for and obtain an LBA license in Indiana within the first 90 days of employment. Job Responsibilities Reviews and interprets patient records and compares them against criteria to determine medical necessity and appropriateness of care; determines if the medical record documentation supports the need for service. Determines approval or initiates doctoral level consultant; processes consultant decision ensuring any denial reason is described in sufficient detail on outgoing correspondence. Performs ongoing assessment of review proc...