Utilization Review Coordinator

Northpoint Recovery Holdings • Meridian, ID

2d • Remote

About The Position

As a key member of the Northpoint team, the Utilization Review Coordinator supports Northpoint’s Utilization Review (UR) function by coordinating the administrative and operational components of the authorization process and providing direct support to Utilization Review Specialists across assigned markets. This position serves as a centralized resource for authorization tracking, payer correspondence, clinical documentation coordination, payer portal activity, record submission, routine payer follow-up, and other activities necessary to support timely authorization of patient services. Working closely with Utilization Review Specialists, Clinical Operations, Assessment Dept, Revenue Cycle Management, and other internal stakeholders, the UR Coordinator helps ensure authorization-related information is complete, submitted timely, accurately documented, and effectively communicated. The position is designed to increase the capacity and effectiveness of the Utilization Review team by reducing administrative burden on UR Specialists, allowing them to focus more heavily on concurrent review, medical necessity, complex payer communication, authorization risk, and denial prevention. The UR Coordinator will also develop foundational knowledge of utilization management, behavioral health levels of care, payer requirements, and authorization processes, creating an opportunity for professional development within the Utilization Review function.

Requirements

• High school diploma or equivalent required
• Previous experience in behavioral health, healthcare administration, utilization management, revenue cycle management, insurance verification, medical billing, payer authorization, or a related healthcare environment preferred.
• Experience working with commercial insurance, Medicaid, Medicare, or managed-care organizations preferred.
• Familiarity with behavioral health levels of care, including residential, PHP, IOP, and outpatient services, preferred.
• Experience with electronic medical records, payer portals, and healthcare revenue-cycle systems preferred.
• Strong organizational and time-management skills with the ability to manage multiple deadlines simultaneously.
• Exceptional attention to detail and accuracy.
• Ability to identify time-sensitive authorization issues and appropriately escalate concerns.
• Strong written and verbal communication skills.
• Ability to communicate professionally with payers and internal stakeholders.
• Working knowledge of healthcare insurance terminology, authorizations, medical necessity, and payer requirements.
• Ability to learn and interpret payer-specific authorization requirements.
• 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 independently research routine issues before escalation.
• Ability to work collaboratively in a fast-paced, multi-market environment.
• Demonstrated 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 related field preferred.
• Experience with KIPU or similar behavioral-health EMR platforms is a plus.

Responsibilities

• Monitor authorization work queues, fax queues, and tracking tools to assist with the management of pending, approved, denied, and expiring authorizations.
• Track authorization dates, approved units/days, expiration dates, payer reference numbers, and other required authorization information.
• Proactively identify upcoming authorization expirations and communicate deadlines or outstanding requirements to the appropriate UR Specialist.
• Coordinate the timely collection and submission of clinical documentation required by payers, including progress notes, treatment plans, assessments, discharge summaries, and other requested records.
• Upload, fax, electronically transmit, or submit clinical documentation through designated payer portals and verify successful receipts.
• Perform routine payer follow-up regarding authorization status, receipt of documentation, outstanding information requests, and other administrative requirements.
• Support UR Specialists in preparing and organizing documentation required 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 within KIPU and other designated systems.
• Coordinate administrative requirements associated with peer-to-peer reviews, payer escalations, and authorization appeals, including scheduling and documentation preparation.
• Support discharge-related UR documentation and ensure appropriate discharge summary of authorization records.
• Maintain organized payer reference materials, authorization requirements, workflows, and departmental resources.
• Assist with the development and maintenance of 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 ensure continuity of information throughout the patient revenue cycle.
• Participate in departmental meetings, training, payer education, and process-improvement initiatives.
• Maintain confidentiality of patient information and comply with HIPAA, organizational policies, payer requirements, and applicable regulatory standards.
• Perform other duties as assigned to support the Utilization Review and Revenue Cycle Management functions.

Benefits

• Subsidized Health Insurance Coverage for Employee, Spouse, & Dependent(s)
• 100% Employer Paid Basic Life Insurance equal to 1x annual salary, up to $100,000
• 100% Employer Paid Employee Assistance Program
• Voluntary Dental, Vision, Short-Term Disability, Supplemental Life & AD&D, Critical Illness, Accident, and Hospital Indemnity Insurance.
• Pre-tax Savings Accounts for all IRS-allowable medical and dependent care expenses
• Generous Paid Time Off plan
• Employee Referral Bonuses
• 401K Retirement Plan & Employer Match

What This Job Offers

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