Behavioral Health, Clinical Data, Clinical Study Publications, Clinical Support, Clinical Validation, Communication Skills, Dental Insurance, Detail Oriented, Electronic Medical Records, Establish Priorities, Health Plan, Insurance, Leadership, Microsoft Excel, Microsoft Word, Multitasking, Organizational Skills, PHP Scripting Language (PHP Hypertext Preprocessor), Patient Care Authorizations, Presentation/Verbal Skills, Process Improvement, Process Management, Psychiatry and Mental Health, Retirement Plan, Team Player, Time Management, Trend Analysis, Utilization Management, Vision Plan, Writing Skills
About Us:
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.
Position Overview:
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.
Key Responsibilities:
Insurance Authorizations:
- 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
Documentation & Systems:
- 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
Collaboration & Communication:
- 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
Denials & Appeals Support:
- 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
Other Duties:
- Perform other responsibilities as assigned to support team goals and company needs
Qualifications:
- 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(preferred)
- 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
Schedule:
M-F(hybrid schedule).
Pay:
$21-$26 per hour depending on experience.
Benefits:
- Medical, dental, and vision insurance
- Life and disability coverage
- Retirement plan
- Paid sick, time off, and holidays
- Employee Assistance Program
- Professional development opportunities
- Other company - sponsored wellness or support programs