Utilization Review (UR) Specialist Location: Chadds Ford, Pennsylvania (Hybrid / Remote Eligible ... Communicate authorization updates with clinical and admissions teams * Maintain accurate ...
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Utilization Review (UR) Specialist Location: Chadds Ford, Pennsylvania (Hybrid / Remote Eligible ... Communicate authorization updates with clinical and admissions teams * Maintain accurate ...
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Utilization Review (UR) Specialist Location: Chadds Ford, Pennsylvania (Hybrid / Remote Eligible ... Communicate authorization updates with clinical and admissions teams * Maintain accurate ...
Steamboat Springs, CO · On-site
$63K - $85K/yr
The Utilization Review Coordinator supports utilization review functions by obtaining and tracking authorizations, maintaining accurate documentation, and ensuring timely communication with payors ...
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Steamboat Springs, CO · On-site
$63K - $85K/yr
The Utilization Review Coordinator supports utilization review functions by obtaining and tracking authorizations, maintaining accurate documentation, and ensuring timely communication with payors ...
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 ...
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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 ...
Utilization Review Specialist Duties/Responsibilities: • Initiate pre-certification and continued stay authorizations based on ASAM criteria • Communicate directly with facility regarding ...
Utilization Review Specialist Duties/Responsibilities: • Initiate pre-certification and continued stay authorizations based on ASAM criteria • Communicate directly with facility regarding ...
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 ...
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 ...
Are you experienced in navigating medical insurance authorizations? We're looking for a Utilization Review Specialist to ensure our inpatient psychiatric patients receive timely access to the care ...
New
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Are you experienced in navigating medical insurance authorizations? We're looking for a Utilization Review Specialist to ensure our inpatient psychiatric patients receive timely access to the care ...
New
Utilization Review Specialist Job Summary: The Utilization Review (UR) Specialist is responsible ... Submit authorization requests and clinical documentation to insurance providers in a timely manner
New
Utilization Review Specialist Job Summary: The Utilization Review (UR) Specialist is responsible ... Submit authorization requests and clinical documentation to insurance providers in a timely manner
New
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 ...
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 ...
Clinically negotiate authorization outcomes with the payor, collaborating in advance with the primary treating clinicians. * Coordinate Peer-to-Peer (P2P) Review preparation and assist with ...
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Clinically negotiate authorization outcomes with the payor, collaborating in advance with the primary treating clinicians. * Coordinate Peer-to-Peer (P2P) Review preparation and assist with ...
Manhattan, NY · On-site
$65K - $75K/yr
Under the direction of the Director of Utilization Review, the Specialist will coordinate Medicaid Managed Care authorizations and re-authorizations for clients receiving behavioral healthcare ...
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Manhattan, NY · On-site
$65K - $75K/yr
Under the direction of the Director of Utilization Review, the Specialist will coordinate Medicaid Managed Care authorizations and re-authorizations for clients receiving behavioral healthcare ...
As a Utilization Review Director joining our team, you're embracing a vital mission dedicated to ... This leader will monitor authorization status for current patients, communicate reimbursement risks ...
As a Utilization Review Director joining our team, you're embracing a vital mission dedicated to ... This leader will monitor authorization status for current patients, communicate reimbursement risks ...
Utilization Review Specialist Job Summary: The Utilization Review (UR) Specialist is responsible ... Submit authorization requests and clinical documentation to insurance providers in a timely manner
New
Quick apply
Utilization Review Specialist Job Summary: The Utilization Review (UR) Specialist is responsible ... Submit authorization requests and clinical documentation to insurance providers in a timely manner
New
Verify insurance benefits , coordinate authorizations, and communicate effectively with managed ... As a Utilization Review Specialist , you'll help ensure that each client leaves treatment with a ...
Quick apply
Verify insurance benefits , coordinate authorizations, and communicate effectively with managed ... As a Utilization Review Specialist , you'll help ensure that each client leaves treatment with a ...
Clinically negotiate authorization outcomes with the payor, collaborating in advance with the primary treating clinicians. * Coordinate Peer-to-Peer (P2P) Review preparation and assist with ...
Quick apply
Clinically negotiate authorization outcomes with the payor, collaborating in advance with the primary treating clinicians. * Coordinate Peer-to-Peer (P2P) Review preparation and assist with ...
Utilization Review Specialist Job Summary: The Utilization Review (UR) Specialist is responsible ... Submit authorization requests and clinical documentation to insurance providers in a timely manner
New
Utilization Review Specialist Job Summary: The Utilization Review (UR) Specialist is responsible ... Submit authorization requests and clinical documentation to insurance providers in a timely manner
New
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 ...
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 ...
... prior authorizations and/or concurrent review. Assesses services for Molina Members to ensure ... Must be an RN Utilization Review background in either Managed Care of Provider environment (at ...
... prior authorizations and/or concurrent review. Assesses services for Molina Members to ensure ... Must be an RN Utilization Review background in either Managed Care of Provider environment (at ...
What you will be doing? The Utilization Review (UR) Specialist is a critical member of the ... This role ensures timely approvals and continued stay authorizations from insurance payers by ...
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What you will be doing? The Utilization Review (UR) Specialist is a critical member of the ... This role ensures timely approvals and continued stay authorizations from insurance payers by ...
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 ...
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 ...
Pompano Beach, FL · Remote
$45K - $65K/hr
Verify insurance benefits , coordinate authorizations, and communicate effectively with managed ... As a Utilization Review Specialist , you'll help ensure that each client leaves treatment with a ...
Pompano Beach, FL · Remote
$45K - $65K/hr
Verify insurance benefits , coordinate authorizations, and communicate effectively with managed ... As a Utilization Review Specialist , you'll help ensure that each client leaves treatment with a ...
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.
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.
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.
Full-time
Medical, Dental, Vision, Life, Retirement, PTO
Posted 8 days ago
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
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
Qualifications
Required:
Preferred:
Requirements
Benefits
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.
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Offices of mental health practitioners
51 - 200 Employees
Milton, PA, US
1991