Utilization Review Coordinator

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.

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