Utilization Review Coordinator

Northpoint Recovery Holdings, LLC • Meridian, ID

5d • $20 - $25 • Remote

About The Position

The Utilization Review Coordinator supports Northpoint’s Utilization Review function by coordinating administrative and operational components of the authorization process and providing direct support to Utilization Review Specialists across assigned markets. The role serves as a centralized resource for authorization tracking, payer correspondence, clinical documentation coordination, payer portal activity, record submission, routine payer follow-up, and related activities that support timely authorization of patient services.

Working with Utilization Review Specialists, Clinical Operations, the Assessment Department, Revenue Cycle Management, and other internal stakeholders, the Coordinator helps ensure authorization information is complete, submitted on time, accurately documented, and effectively communicated. The role reduces administrative workload for UR Specialists so they can focus on concurrent review, medical necessity, complex payer communication, authorization risk, and denial prevention. It also provides an opportunity to develop foundational knowledge of utilization management, behavioral health levels of care, payer requirements, and authorization processes.

Requirements

• High school diploma or equivalent.
• Strong organizational and time-management skills, including the ability to manage multiple deadlines.
• Exceptional attention to detail and accuracy.
• Ability to identify time-sensitive authorization issues and escalate concerns appropriately.
• Strong written and verbal communication skills and ability to communicate professionally with payers and internal stakeholders.
• Strong computer skills and ability to work across multiple systems, payer portals, and tracking tools.
• Ability to maintain accurate documentation and detailed records.
• Strong problem-solving skills and willingness to research routine issues independently before escalating.
• Ability to work collaboratively in a fast-paced, multi-market environment.
• Professionalism and discretion when handling confidential patient and organizational information.

Nice To Haves

• Associate or bachelor’s degree in healthcare administration, behavioral health, business administration, health information management, or a related field.
• Previous experience in behavioral health, healthcare administration, utilization management, revenue cycle management, insurance verification, medical billing, payer authorization, or a related healthcare environment.
• Experience working with commercial insurance, Medicaid, Medicare, or managed-care organizations.
• Familiarity with behavioral health levels of care, including residential, PHP, IOP, and outpatient services.
• Experience with electronic medical records, payer portals, and healthcare revenue-cycle systems.
• Experience with KIPU or similar behavioral-health EMR platforms.
• Working knowledge of healthcare insurance terminology, authorizations, medical necessity, and payer requirements.
• Ability to learn and interpret payer-specific authorization requirements.

Responsibilities

• Monitor authorization work queues, fax queues, and tracking tools to assist with pending, approved, denied, and expiring authorizations.
• Track authorization dates, approved units or days, expiration dates, payer reference numbers, and other required authorization information.
• Identify upcoming authorization expirations and communicate deadlines or outstanding requirements to the appropriate UR Specialist.
• Coordinate timely collection and submission of clinical documentation requested by payers, including progress notes, treatment plans, assessments, discharge summaries, and other records.
• Upload, fax, electronically transmit, or submit clinical documentation through payer portals and verify successful receipt.
• Perform routine payer follow-up regarding authorization status, documentation receipt, outstanding information requests, and other administrative requirements.
• Support UR Specialists in preparing and organizing documentation for initial and concurrent authorization reviews.
• Assist with payer portal activity, authorization status verification, and other non-clinical payer communication.
• Maintain accurate and timely authorization information, payer correspondence, and supporting documentation in KIPU and other designated systems.
• Coordinate administrative requirements for peer-to-peer reviews, payer escalations, and authorization appeals, including scheduling and documentation preparation.
• Support discharge-related UR documentation and ensure appropriate discharge summaries of authorization records.
• Maintain payer reference materials, authorization requirements, workflows, and departmental resources.
• Assist with developing and maintaining UR standard operating procedures, payer guides, workflows, and training materials.
• Provide cross-market support based on authorization volume, staffing needs, and departmental priorities.
• Partner with Clinical Operations, Admissions, Billing, and other RCM functions to resolve routine authorization-related issues and support continuity of information throughout the patient revenue cycle.
• Participate in departmental meetings, training, payer education, and process-improvement initiatives.
• Maintain patient confidentiality and comply with HIPAA, organizational policies, payer requirements, and applicable regulatory standards.
• Perform other duties as assigned to support Utilization Review and Revenue Cycle Management.

Benefits

• Subsidized health insurance coverage for the employee, spouse, and dependents.
• Employer-paid basic life insurance equal to 1x annual salary, up to $100,000.
• Employer-paid Employee Assistance Program.
• Voluntary dental, vision, short-term disability, supplemental life and AD&D, critical illness, accident, and hospital indemnity insurance.
• Pre-tax savings accounts for eligible medical and dependent care expenses.
• Generous paid time off plan.
• Employee referral bonuses.
• 401(k) retirement plan with employer match.

What This Job Offers

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