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Authorization Utilization Review Bcba Jobs (NOW HIRING)

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 ...

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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Authorization Utilization Review Bcba information

What are the key skills and qualifications needed to thrive in the Authorization Utilization Review Bcba position, and why are they important?

To thrive as an Authorization Utilization Review BCBA, you need a strong background in applied behavior analysis, in-depth knowledge of utilization review processes, and active BCBA certification. Familiarity with insurance authorization platforms, electronic health record (EHR) systems, and current procedural terminology (CPT) coding is typically required. Excellent analytical skills, attention to detail, and effective communication abilities set outstanding candidates apart. These skills ensure accurate authorization decisions, regulatory compliance, and efficient collaboration with providers and insurance teams.

What are the primary responsibilities of an Authorization Utilization Review BCBA on a typical day?

An Authorization Utilization Review BCBA is primarily responsible for reviewing clinical documentation to determine the medical necessity of ABA services, preparing and submitting authorization requests to insurance companies, and responding to requests for additional information. The role involves collaborating closely with clinical staff, insurance representatives, and sometimes directly with clients or caregivers to ensure all documentation meets regulatory and payer requirements. You may also provide guidance to therapy teams on proper documentation and help streamline internal utilization review processes. This position requires balancing client advocacy with payer guidelines, making each day both detailed and dynamic.

What is an Authorization Utilization Review BCBA job?

An Authorization Utilization Review BCBA is responsible for reviewing treatment plans, ensuring medical necessity, and obtaining insurance authorizations for applied behavior analysis (ABA) services. They analyze data, collaborate with clinicians, and communicate with insurance providers to optimize care while adhering to policies and guidelines. Their goal is to ensure that ABA services are both effective and appropriately funded within insurance requirements.

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Authorization Utilization Review Bcba jobs near you

Utilization Review Specialist

Diversified Treatment Alternative Centers

Chadds Ford, PA • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 8 days ago

Job description

Salary:

Utilization Review (UR) Specialist

Location: Chadds Ford, Pennsylvania (Hybrid / Remote Eligible)
Job Type: Full-Time
Schedule: Monday Friday


Overview

Diversified Treatment Alternative Centers (DTAC) is seeking a detail-oriented and experienced Utilization Review (UR) Specialist to support our behavioral health programs.

This role plays a critical part in ensuring services are medically necessary, appropriately authorized, and compliant with payer, state, and regulatory requirements while supporting timely reimbursement and quality care delivery.


Why Join DTAC

  • Flexible hybrid or remote work options
  • Collaborative, cross-functional team environment
  • Meaningful work supporting behavioral health services
  • Stable organization focused on quality and growth
  • Opportunities for professional development


Position Summary

The Utilization Review Specialist manages the full lifecycle of authorizations and eligibility verification. This role collaborates closely with Clinical, Admissions, and Revenue Cycle teams to ensure compliance, minimize denials, and support accurate billing and reimbursement.


Key Responsibilities

  • Conduct initial, concurrent, and continued stay utilization reviews
  • Submit, track, and manage authorizations and reauthorizations
  • Communicate authorization updates with clinical and admissions teams
  • Maintain accurate documentation in EHR and billing systems
  • Perform ongoing eligibility verification for active clients
  • Identify coverage changes and communicate impacts to appropriate teams
  • Review clinical documentation for medical necessity and compliance
  • Collaborate with clinicians to address documentation gaps
  • Support denial prevention and revenue cycle optimization
  • Assist with appeals and utilization-related inquiries
  • Participate in audits, quality improvement initiatives, and compliance reviews
  • Stay current with payer requirements and regulatory updates


Qualifications

Required:

  • Bachelors degree in Healthcare Administration, Nursing, Social Work, Psychology, or related field
  • Minimum of 13 years of experience in utilization review, case management, or behavioral health revenue cycle
  • Strong understanding of medical necessity and authorization processes
  • Excellent attention to detail and analytical skills
  • Strong written and verbal communication skills

Preferred:

  • Experience with Pennsylvania and Ohio behavioral health payers
  • Familiarity with EHR systems and billing workflows
  • Experience supporting audits, compliance reviews, or appeals


Requirements

  • Ability to manage multiple priorities and deadlines
  • Strong collaboration across clinical, billing, and administrative teams
  • Commitment to compliance with regulatory and payer requirements
  • Ability to work hybrid or remotely depending on organizational needs


Benefits

  • 401(k)
  • Health, Dental, and Vision Insurance
  • Health Savings Account
  • Paid Time Off
  • Life and Disability Insurance
  • Employee Assistance Program
  • Referral Program


Work Location

This position is based in Chadds Ford, PA (19317) with hybrid or remote work options available based on business needs.


Apply Today

If you are a detail-driven professional with experience in utilization review or behavioral health operations, we encourage you to apply and join DTACs team.


Equal Opportunity Employer

Diversified Treatment Alternative Centers is committed to providing equal employment opportunities and maintaining an inclusive workplace in accordance with all applicable laws.