UR Coordinator, Full Time
About The Position
RiverVista is located in Columbus, Ohio and serves Franklin and surrounding counties. The focus is on behavioral health for inpatient and outpatient treatments. We serve the adults and older adult patients to guide them through their mental health struggles. We have been in this location since 2018 and have quickly gained a reputation for being a highly-sought behavioral health treatment center. RiverVista is seeking a detail-oriented and knowledgeable Utilization Review (UR) Coordinator to support clinical documentation, insurance authorization processes, and regulatory compliance. This role ensures appropriate level-of-care determinations, timely payer communication, and accurate clinical documentation to support resident care and reimbursement.
Requirements
- High school diploma required
- Must be 21 or older
- Experience in utilization review, case management, medical records, or healthcare billing strongly preferred
- Strong understanding of insurance authorization processes (Medicare, Medicaid, and commercial payers)
- Knowledge of medical terminology and clinical documentation standards
Nice To Haves
- associate or bachelor’s degree in nursing, healthcare administration, or related field preferred
Responsibilities
- Review patient charts to ensure medical necessity and appropriate level of care
- Coordinate and submit insurance authorizations, continued stay reviews, and denials/appeals
- Communicate with insurance providers, case managers, and clinical staff regarding coverage and updates
- Monitor utilization of services to ensure compliance with payer guidelines and facility policies
- Collaborate with nursing, admissions, and billing teams to support accurate documentation and reimbursement
- Track authorization dates, renewals, and required clinical updates
- Assist with audit preparation and regulatory compliance reviews
- Maintain confidentiality and ensure adherence to HIPAA standards
Benefits
- Multiple medical plan options, Vista Wellness (physician/pharmacy), Dental, Vision
- Generous PTO and paid holidays
- 401(k) with company contribution; Life and disability coverage
- Tuition reimbursement up to $15,000 and student loan forgiveness programs
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
