ABA Utilization Review Specialist

Spectrum Billing Solutions • Skokie, IL

1d

About The Position

Spectrum Billing Solutions provides revenue cycle management services for healthcare providers. The ABA Utilization Review Specialist reviews clinical information and obtains initial and continuing authorizations for ABA and related services. The position may be fully remote or office/home hybrid.

Requirements

• 3–5 years of utilization review experience.
• Superior written and oral communication skills.
• Attention to detail to ensure necessary information is captured and properly documented.
• Ability to work independently and within a team.
• Ability to multitask, prioritize, and meet expected deadlines.
• Solid understanding of insurance benefits and coverages.
• Strong computer skills, including Word, Excel, and billing software.

Nice To Haves

• ABA and/or behavioral health experience preferred.
• Bachelor’s or master’s degree preferred.

Responsibilities

• Review patient admission and clinical information to ensure medical necessity and compliance with utilization review guidelines.
• Obtain initial and continuing authorization for treatment services.
• Manage authorization denials, including referral for peer review.
• Document and record necessary information.
• Monitor and track new and ongoing authorization cases.
• Collaborate and communicate with clinical staff to obtain necessary information and ensure timely reviews.
• Assist external clients in understanding payer requirements for authorizations.
• Participate in team meetings.
• Maintain confidentiality of patient information and adhere to HIPAA regulations.

Benefits

• Flexible work environment.
• Competitive salary.
• Growth opportunities.
• Medical, dental, and vision benefits.
• Flexible paid time off.
• 401(k) with company match.
• Supplemental benefits.

What This Job Offers

• Job Type: Full-time
• Education Level: No Education Listed