Utilization Review Coordinator

Mountainside Treatment Center • Canaan, CT

11h • $24 - $26

About The Position

The Utilization Review Coordinator ensures clients receive the appropriate level of care by coordinating with insurance providers, reviewing clinical documentation, and collaborating with treatment teams. The role supports insurance authorization and continuity of care, monitors coverage and length of stay, and contributes to improving review workflows and documentation practices.

The schedule is Sunday through Thursday, 8:00 AM to 4:30 PM. The position is based in Canaan, Connecticut, at Mountainside Treatment Center, a behavioral healthcare provider focused on alcohol dependency and drug addiction.

Requirements

• Bachelor’s degree in a related field.
• Experience working with insurance from a utilization review perspective.
• Experience working with DSM-IV and knowledge documentation.
• Excellent communication, organization, and time management skills.

Nice To Haves

• Certification in Addiction Counseling is preferred.

Responsibilities

• Conduct utilization reviews to ensure appropriate levels of care for clients.
• Collaborate with clinical teams to gather and review documentation for insurance authorization.
• Communicate with insurance providers to obtain treatment approvals and extensions.
• Monitor length of stay and identify potential barriers to continued coverage.
• Ensure compliance with ASAM criteria and other industry standards.
• Track and analyze key performance indicators related to authorization success rates.
• Identify trends in insurance denials and work with teams to improve documentation quality.
• Assist in coordinating appeals for denied claims by providing clinical justification.
• Work with the Crisis Intervention team, Recovery Coaching, Outpatient, and Residential departments to ensure continuity of care.
• Maintain accurate records of authorizations, denials, and appeals in relevant systems.
• Contribute insights from utilization review trends to support program development.
• Participate in team meetings and provide updates on insurance-related challenges and successes.
• Assist with training new staff on utilization review processes and documentation best practices.
• Use tech-enabled solutions to streamline review and authorization workflows.
• Follow up promptly on pending authorizations and communicate updates to relevant stakeholders.

Benefits

• Comprehensive benefit package.
• Paid time off, which increases after one year with Mountainside.
• Paid holidays, including a Multicultural Holiday.
• 401(k) with employer matching.
• Free meals while working on the Canaan campus.
• Monthly $75 wellness reimbursement to encourage self-care and help avoid burnout and compassion fatigue.

What This Job Offers

• Job Type: Full-time