ZipRecruiter

Log In

1

Behavioral Utilization Review Jobs in Florida (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 ... Work closely with interdisciplinary teams, Board Certified Behavior Analysts, Registered Behavior ...

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 ... Work closely with interdisciplinary teams, Board Certified Behavior Analysts, Registered Behavior ...

ICBD

Utilization Review Specialist

Lauderdale Lakes, FL

$55K - $70K/yr

Utilization Review Specialist - Exact Billing Solutions (EBS) Lauderdale Lakes, FL - On-site - No ... Work closely with interdisciplinary teams, Board Certified Behavior Analysts, Registered Behavior ...

ICBD

Utilization Review Manager

Lauderdale Lakes, FL · On-site

... of behavioral health experience (preferred). * Willingness to submit to drug and background screenings. * Certifications in utilization review (e.g., URAC) are advantageous. Expertise Needed

next page

Showing results 1-20

People also search for

All JobsBehavioral Utilization Review JobsBehavioral Utilization Review Jobs in Florida

Behavioral Utilization Review information

What is the difference between Behavioral Utilization Review vs Behavioral Case Manager?

AspectBehavioral Utilization ReviewBehavioral Case Manager
CredentialsLicensed mental health professionals, certifications varyLicensed clinical social workers, counselors, or therapists
Work EnvironmentReview settings, insurance companies, healthcare facilitiesDirect patient interaction, hospitals, outpatient clinics
Employer & IndustryInsurance companies, healthcare organizationsHospitals, mental health agencies, managed care
Primary FocusAssessing medical necessity, reviewing treatment plansCoordinating care, supporting treatment adherence

Behavioral Utilization Review primarily involves evaluating the necessity of mental health services through review processes, while Behavioral Case Managers focus on coordinating patient care and supporting treatment plans. Both roles require mental health credentials but differ in daily tasks and work settings.

What are popular job titles related to Behavioral Utilization Review jobs in Florida? For Behavioral Utilization Review jobs in Florida, the most frequently searched job titles are:
What job categories do people searching Behavioral Utilization Review jobs in Florida look for? The top searched job categories for Behavioral Utilization Review jobs in Florida are:
What cities in Florida are hiring for Behavioral Utilization Review jobs? Cities in Florida with the most Behavioral Utilization Review job openings:
Behavioral Utilization Review jobs near you
Infographic showing various Behavioral Utilization Review job openings in Florida as of May 2026, with employment types broken down into 56% Full Time, 38% Part Time, and 6% Contract. Highlights an 95% Physical, 2% Hybrid, and 3% Remote job distribution.
Utilization Review Specialist

Utilization Review Specialist

ICBD Holdings LLC

Lauderdale Lakes, FL • On-site

$55K - $70K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

This job post has expired today. Applications are no longer accepted.

Job description

Utilization Review Specialist - Exact Billing Solutions (EBS)
Lauderdale Lakes, FL - On-site - No Remote
Salary: $55K - $70K
Who We Are
Exact Billing Solutions is a unique team of revenue cycle management professionals specializing in the substance use disorder, mental health, and autism care fields of healthcare services. We have extensive industry knowledge, a deep understanding of the specific challenges of these markets, and a reputation for innovation. With our proprietary billing process, EBS is the oil that brings life to the engines of its partner healthcare companies.
Part of the ICBD portfolio, Exact Billing Solutions combines entrepreneurial speed with the financial discipline of a self-funded, founder-led organization. Our growth reflects a proven ability to solve complex healthcare challenges with operational precision, scalable systems, and client-first innovation.
Recognition & Awards
Exact Billing Solutions contributes heavily to the success of the broader ICBD corporate ecosystem and benefits from the recognition awarded to other portfolio companies, including:
  • Inc. 5000 - 25th Fastest-Growing Private Company in America (2025).
  • Financial Times - #5 on "The Americas' Fastest Growing Companies."
  • EY Entrepreneur Of The Year U.S. Overall.
  • South Florida Business Journal's Top 100 Companies.
  • Florida Trend Magazine's 500 Most Influential Business Leaders.
  • Inc. Best in Business, Health Services.
About the Role
As a Utilization Review Specialist, you will play a pivotal role in ensuring the efficient and effective utilization of healthcare resources.
The UR Records Specialist will assist in reviewing and processing records to submit for authorization to the payors. This position collaborates closely with clinical teams, insurance providers, and other healthcare professionals to support efficient and effective patient care.
Key Responsibilities
  • Review and analyze clinical records, including received documentation from payors, to ensure compliance with ABA therapy best practices and insurance requirements.
  • Accurately input and maintain clinical records, authorization requests, and related documents into the electronic health records (EHR) or other relevant systems.
  • Assist in tracking and organizing all documentation for utilization reviews, ensuring that all records are complete, accurate, and accessible for audits and reviews.
  • Monitor the status of pending authorizations and document updates or changes to treatment plans in a timely manner.
  • Assist in processing and reviewing requests for treatment authorization, working with clinicians to verify that all necessary documentation is available for review.
  • Assess the appropriateness and necessity of healthcare services, ensuring they align with established guidelines and policies.
  • Work closely with interdisciplinary teams, Board Certified Behavior Analysts, Registered Behavior Technicians, and other healthcare professionals to gather insights and ensure comprehensive reviews.
  • Assist in preparing records and documentation for external audits or insurance company reviews, ensuring that all necessary information is submitted and compliant with guidelines.
  • Identify any discrepancies, missing documentation, or areas where clinical records may require updates to meet the standards.
  • Assist in coordinating with insurance providers to obtain authorization and resolve any issues related to service utilization or claims denials.
  • Provide requested documentation and supporting materials for authorization and reauthorization requests, ensuring timely submission to insurance companies.
  • Maintain records of communications with insurance companies, clinical teams, and other relevant stakeholders.
  • Analyze trends in authorization requests, approvals, and denials and provide reports or insights to management to identify areas for process improvement.
  • Track utilization patterns, service delivery, and compliance with payer requirements to support continuous improvement in the utilization review process.
  • Communicate effectively with team members to ensure the smooth processing of treatment authorizations and timely updates on status or concerns.
  • Provide clear communication regarding the status of clinical record reviews, authorization requests, and insurance queries.
  • Participate in quality-improvement initiatives to enhance the overall efficiency and effectiveness of healthcare delivery.
Requirements
  • Associate's or Bachelor's degree in Healthcare Administration, Medical Records, Behavioral Health, or a related field.
  • Certification in Health Information Management (e.g., RHIA, RHIT) is a plus but not required.
  • Minimum of 1 year of experience working with clinical records, medical documentation, or utilization review, preferably in ABA therapy, behavioral health, or healthcare settings.
  • Proven experience in utilization reviews or a related field with a strong understanding of healthcare service delivery and documentation processes is highly desirable.
  • Must maintain clean background/drug screenings and driving record.
Expertise Needed
  • Familiarity with industry standards, guidelines, and best practices related to utilization review.
  • Ability to analyze complex clinical documentation, treatment plans, and medical records.
  • Strong critical thinking skills to assess the appropriateness and necessity of healthcare services.
  • Strong analytical and critical thinking skills.
  • Excellent communication and interpersonal skills.
Benefits
  • 21 paid days off (15 PTO days increasing with tenure, plus 6 paid holidays)
  • Flexible Spending Account (FSA) and Health Savings Account (HSA) options
  • Medical, dental, vision, long-term disability, life insurance, AD&D insurance, and GAP Plan (TransAmerica)
  • Generous 401(k) with up to 6% employer match
  • 100% employer-paid maternity/paternity leave for up to 5 weeks
  • Tuition reimbursement up to $2,500 per semester
  • EAP (unlimited counseling 24/7), BeyondMed (discounts on wellness and elective healthcare services), PerkSpot (discounts on top brands), Pet Insurance (Nationwide), and On the GoGa wellbeing hub

Closing Statement
Exact Billing Solutions is an Equal Opportunity Employer and is committed to building an inclusive workplace free from discrimination. We make employment decisions based on qualifications, merit, and business needs, and do not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other protected characteristic under applicable law.
Exact Billing Solutions participates in the U.S. Department of Homeland Security E-Verify program.

Apply