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Authorization Utilization Review Jobs (NOW HIRING)

US Tech Solutions

Utilization Review Nurse

Chicago, IL · On-site

Reviews documentation and evaluates Potential Quality of Care issues based on clinical policies and ... Must have prior authorization utilization experience * Experience with Medcompass Skills: * MUST ...

ICBD

Utilization Review Specialist

Lauderdale Lakes, FL · On-site

$55K - $70K/yr

Utilization Review Specialist - Exact Billing Solutions (EBS) Lauderdale Lakes, FL - On-site - No ... Monitor the status of pending authorizations and document updates or changes to treatment plans in ...

ICBD

Utilization Review Specialist

Lauderdale Lakes, FL · On-site

$55K - $70K/yr

Utilization Review Specialist - Exact Billing Solutions (EBS) Lauderdale Lakes, FL - On-site - No ... Monitor the status of pending authorizations and document updates or changes to treatment plans in ...

ICBD

Utilization Review Specialist

Lauderdale Lakes, FL · On-site

$55K - $70K/yr

Utilization Review Specialist - Exact Billing Solutions (EBS) Lauderdale Lakes, FL - On-site - No ... Monitor the status of pending authorizations and document updates or changes to treatment plans in ...

GRO Community

Utilization Review Manager

Chicago, IL · On-site

Utilization Review & Authorization Management * Conduct ongoing utilization reviews of client treatment plans, progress notes, and service delivery to ensure alignment with payer and regulatory ...

GRO Community

Utilization Review Manager

Chicago, IL · On-site

Utilization Review & Authorization Management * Conduct ongoing utilization reviews of client treatment plans, progress notes, and service delivery to ensure alignment with payer and regulatory ...

PARKSIDE INC

Utilization Review Specialist

Tulsa, OK · On-site

The Utilization Review Specialist asses, plans, implements and evaluates the internal processes to ... Responsibilities: • Prepares authorization paperwork, processes requests for authorizations, and ...

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How much do authorization utilization review jobs pay per hour?

As of Jul 13, 2026, the average hourly pay for authorization utilization review in the United States is $42.28, according to ZipRecruiter salary data. Most workers in this role earn between $33.41 and $48.56 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as an Authorization Utilization Review Specialist, and why are they important?

To thrive as an Authorization Utilization Review Specialist, you need a solid understanding of medical terminology, healthcare regulations, and insurance policies, often backed by a clinical background or relevant certifications. Familiarity with utilization management software, electronic health records (EHR), and payer portals is typically required. Strong attention to detail, analytical thinking, and effective communication are vital soft skills for coordinating with providers and payers. These skills ensure accurate authorization decisions, regulatory compliance, and efficient patient care coordination.

What are some common challenges faced by professionals in Authorization Utilization Review roles, and how can they be addressed?

Professionals in Authorization Utilization Review often encounter challenges such as managing high caseloads, navigating complex insurance guidelines, and ensuring timely communication with providers and patients. Staying organized and up-to-date with evolving payer requirements is essential to avoid delays or denials. Building strong collaboration with clinical teams and leveraging electronic health record systems can help streamline workflows and improve efficiency in the review process.

What is the difference between Authorization Utilization Review vs Claims Reviewer?

AspectAuthorization Utilization ReviewClaims Reviewer
CredentialsTypically requires healthcare or insurance-related certifications, such as RN, CPC, or licensed healthcare professionalsOften requires similar credentials, focusing on insurance policies and claims processing
Work EnvironmentHospitals, insurance companies, healthcare facilitiesInsurance companies, third-party administrators, healthcare organizations
Industry UsageUsed to assess medical necessity before approving servicesUsed to evaluate claims for payment accuracy and compliance

Authorization Utilization Review and Claims Reviewer roles both involve insurance and healthcare knowledge, but Authorization Utilization Review focuses on pre-authorization of services, while Claims Review centers on post-service claims assessment. Understanding these differences helps clarify career paths and job expectations in healthcare insurance.

What is Authorization Utilization Review?

Authorization Utilization Review is a process used by healthcare organizations and insurance companies to assess the medical necessity and appropriateness of medical services before they are provided. The main goal is to ensure that patients receive care that is effective, efficient, and covered by their health plan. This review typically involves evaluating patient records, treatment plans, and provider requests to decide if the requested services meet established guidelines. By doing so, it helps control healthcare costs and ensures quality care for patients.
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What cities are hiring for Authorization Utilization Review jobs? Cities with the most Authorization Utilization Review job openings:
What states have the most Authorization Utilization Review jobs? States with the most job openings for Authorization Utilization Review jobs include:
What job categories do people searching Authorization Utilization Review jobs look for? The top searched job categories for Authorization Utilization Review jobs are:
Authorization Utilization Review jobs near you
Infographic showing various Authorization Utilization Review job openings in the United States as of July 2026, with employment types broken down into 1% As Needed, 88% Full Time, 10% Part Time, and 1% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

Utilization Review Coordinator | Remote

Atlantic Health Strategies

Boca Raton, FL • On-site, Remote

$50K - $80K/yr

Full-time

Posted 14 days ago

Job description


About the Organization
Lotus Healthcare Billing is a behavioral health billing operation based in Boca Raton, Florida, supporting treatment programs through insurance authorization, utilization review, and payer communication. The team works closely with clinical staff to ensure that patients can access the levels of care they need, from detox through outpatient services.
The Opportunity
We are seeking a detail-oriented Utilization Review Coordinator to join the Lotus Healthcare Billing team. This full-time, remote role is well suited to someone who is organized, communicates clearly, and is comfortable managing a caseload where timelines directly affect patient care. A hybrid schedule with time in the Boca Raton office may be available for the right candidate. No prior utilization review experience is required. Training will be provided for the right candidate.
What You'll Do
  • Conduct daily phone contact with insurance companies to secure authorizations for behavioral health and substance use disorder treatment.
  • Manage a caseload of active authorizations, tracking timelines closely since they directly affect patient care.
  • Apply knowledge of SUD and behavioral health levels of care, including detox, residential, PHP, IOP, and outpatient, when communicating with payers.
  • Reference ASAM criteria and medical necessity standards to support authorization requests.
  • Use systems such as KIPU, Availity, or other payer portals to document and track review activity.
  • Communicate professionally and consistently with insurance representatives and internal clinical teams.
  • Work independently while staying aligned with program and compliance expectations.

Requirements
Requirements
  • High school diploma or equivalent required; associate's or bachelor's degree a plus.
  • Less than one year of relevant experience required; training provided for the right candidate.
  • Experience in utilization review, insurance authorization, or behavioral health billing preferred.
  • Familiarity with SUD/behavioral health levels of care (detox, residential, PHP, IOP, OP) is a strong plus.
  • Knowledge of ASAM criteria and medical necessity standards a plus.
  • Experience with KIPU, Availity, or payer portals preferred.
  • Strong organizational skills and attention to detail.
  • Clear, professional communication skills.
  • Comfortable working independently and managing a caseload.
  • Reliable home internet and a private, HIPAA-compliant workspace for remote work.

Benefits
Compensation and Schedule
  • Salary: $50,000 to $80,000 annually, commensurate with experience.
  • Schedule: Days, full-time, remote (hybrid option available for the right candidate).

This opportunity is posted by Atlantic Health Strategies on behalf of Lotus Healthcare Billing in Boca Raton, Florida.

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