Utilization Review Coordinator – Behavioral Health

Avenues Recovery • Toms River, NJ

5d • Onsite

About The Position

Avenues Recovery Center is seeking a Utilization Review Specialist to join their corporate team in New Jersey. This role supports authorization, clinical documentation integrity, and continued stay coordination across their nationwide network of drug and alcohol rehabilitation centers. The Utilization Review Specialist ensures timely authorization of client services, supports appropriate level-of-care determinations, and partners closely with clinical and billing teams to maintain accurate documentation and continuity of care across facilities. This role requires strong communication, attention to detail, and the ability to collaborate across clinical, administrative, and billing departments.

Requirements

• High school diploma or GED required
• Strong communication (written and verbal)
• Excellent interpersonal and collaboration skills
• Strong attention to detail and documentation accuracy
• Ability to manage multiple cases and deadlines
• Sound judgment and critical thinking
• Flexible, team-oriented, and adaptable in a fast-paced environment
• Willing to train

Nice To Haves

• Bachelor's degree preferred
• Nursing background, clinical background or healthcare knowledge strongly preferred
• Minimum 1 year of experience in behavioral health, healthcare, or treatment setting preferred
• Experience with utilization review, insurance authorization, or medical billing strongly preferred

Responsibilities

• Field incoming calls, emails, and documentation requests related to client authorizations
• Ensure timely approval and continuation of services at the appropriate level of care
• Manage client caseloads and support authorization workflows across facilities
• Advocate for continued stay based on clinical documentation and treatment needs
• Work closely with billing and clinical teams to identify and resolve authorization issues
• Communicate with facility leadership regarding UR status and documentation needs
• Support coordination between treatment teams and administrative departments
• Maintain accurate electronic records of all UR activity and authorization communications
• Ensure documentation meets internal standards and payer requirements
• Assist in identifying gaps in charting and supporting improvements in documentation workflows
• Assist in creating standardized templates and UR workflows across facilities
• Work with site leaders to ensure consistent implementation of processes
• Support improvement of internal UR systems and efficiency initiatives

Benefits

• 401(k) with employer match
• Medical, Dental, and Vision Insurance
• Accident, Critical Illness, and Hospital Indemnity coverage
• Employer-paid Life and AD&D Insurance
• Short- and Long-Term Disability options
• Legal coverage and Identity Theft Protection
• Pet Insurance
• Employee Assistance Program (EAP)
• Flexible Spending Accounts (Medical & Dependent Care)

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED