Utilization Review Coordinator
About The Position
Your Behavioral Health is dedicated to providing exceptional, evidence-based mental health and addiction treatment through Clear Behavioral Health and Neuro Wellness Spa. Our UR team plays a vital role in ensuring clients receive timely and medically necessary care. We are seeking a detail-oriented, proactive Utilization Review (UR) Coordinator to support insurance authorization processes across all levels of care — including Detox, Residential, PHP, IOP — as well as Transcranial Magnetic Stimulation (TMS) services. The UR Coordinator will collaborate closely with clinical teams and payors to advocate for clients, secure appropriate insurance authorizations, and support a smooth treatment experience.
Requirements
- 1–2 years of utilization review experience, preferably in behavioral health or mental health settings
- Experience obtaining Detox, Residential, PHP, and IOP authorizations with commercial payors
- Familiarity with TMS treatment and authorization processes
- Experience with commercial health plans and payor authorization protocols
- Proficiency with EMR systems, Microsoft Word, and Excel
- Strong written and verbal communication skills
- Ability to multitask, prioritize, and work efficiently in a fast-paced environment
- Professional, collaborative, and passionate about patient advocacy
Responsibilities
- Obtain initial and concurrent authorizations for Detox, Residential, PHP, and IOP programs
- Obtain TMS service authorizations for Neuro Wellness Spa
- Conduct clinical reviews and advocate with commercial health plans to support medically necessary care
- Track authorization timelines and follow up promptly on outstanding requests
- Maintain accurate, real-time records of authorization activity
- Gather and review clinical documentation to support authorization requests
- Document all communications with payors clearly and thoroughly
- Communicate regularly with insurance representatives, clinical teams, and leadership about authorization status and updates
- Work collaboratively with the UR team to improve processes and enhance coordination of care
- Assist with denial management, support appeal efforts with case summaries and clinical data
- Help identify trends in authorization delays or denials and provide input to leadership
- Perform other responsibilities as assigned to support team goals and company needs
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
No Education Listed
