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Commission Authorization Utilization Review Bcba Jobs

Discovery Institute

Utilization Review

Marlboro, NJ · On-site

Position Summary The Utilization Review (UR) Specialist is responsible for obtaining and ... authorization status, denials, appeals, and payer trends. * Ensure compliance with Joint Commission ...

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 ...

US Tech Solutions

Utilization Review Nurse

Canton, MA · On-site

$55 - $60/hr

Communicate authorization decisions with physicians, provider offices, hospitals, and healthcare ... Utilization Management (UM) * Medical Necessity Review * Prior Authorization * Precertification

Acrisure LLC

Utilization Review Nurse

Bradenton, FL · On-site

... authorized at the nurse level, and refers requests for physician review when additional clinical ... Experience in utilization review or case management is highly beneficial, particularly within ...

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$191.3K

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How much do commission authorization utilization review bcba jobs pay per year?

As of Aug 29, 2026, the average yearly pay for commission authorization utilization review bcba in the United States is $191,250.00, according to ZipRecruiter salary data. Most workers in this role earn between $141,000.00 and $253,500.00 per year, depending on experience, location, and employer.

What is the difference between Commission Authorization Utilization Review Bcba vs Behavior Analyst?

AspectCommission Authorization Utilization Review BcbaBehavior Analyst
CertificationsBCBA, additional authorization for utilization reviewBCBA, Board Certified Behavior Analyst
Work EnvironmentUtilization review teams, healthcare settingsClinical practice, therapy sessions, research
Employer & Industry UsageInsurance companies, healthcare organizationsClinics, schools, private practice

The Commission Authorization Utilization Review BCBA focuses on reviewing and authorizing services for insurance and healthcare providers, while the Behavior Analyst primarily provides direct behavioral therapy and assessments. Both roles require BCBA certification, but their work environments and responsibilities differ significantly.

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Commission Authorization Utilization Review Bcba jobs near you
Infographic showing various Commission Authorization Utilization Review Bcba job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 82% Full Time, 13% Part Time, 3% Contract, and 1% Nights. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $191,250 per year, or $91.9 per hour.

Utilization Review

Discovery Institute NJ

Marlboro, NJ • On-site

Full-time

Re-posted 6 days ago

Job description

Position Summary
The Utilization Review (UR) Specialist is responsible for obtaining and maintaining insurance authorizations for clients receiving substance use disorder treatment services. This position works closely with clinical staff, admissions, and insurance companies to ensure medical necessity documentation is accurate, authorizations are obtained timely, and reimbursement is maximized while maintaining compliance with payer requirements, Medicaid regulations, and accreditation standards.
Essential Duties and Responsibilities
  • Obtain initial and concurrent insurance authorizations for all levels of care.
  • Review clinical documentation to ensure it supports medical necessity.
  • Submit clinical information to insurance companies within required timeframes.
  • Monitor authorization expiration dates and request extensions before expiration.
  • Communicate authorization decisions and payer requirements to clinical staff.
  • Track approved days and notify leadership of denials or reductions in care.
  • Prepare and submit appeals for denied services when appropriate.
  • Maintain accurate authorization records in the electronic health record (EHR).
  • Work collaboratively with Admissions, Clinical, Nursing, and Billing departments.
  • Verify insurance benefits and coverage when necessary.
  • Monitor payer portals for authorization updates.
  • Assist with Medicaid and managed care authorization processes.
  • Participate in utilization review meetings and case conferences.
  • Generate reports on authorization status, denials, appeals, and payer trends.
  • Ensure compliance with Joint Commission, state, federal, and payer regulations.
  • Maintain confidentiality in accordance with HIPAA regulations.
  • Perform other duties as assigned.
Qualifications
  • High school diploma required; Associate's or Bachelor's degree preferred.
  • Minimum of two years of utilization review, case management, medical billing, or behavioral healthcare experience preferred.
  • Experience in substance use disorder or behavioral health treatment strongly preferred.
  • Knowledge of ASAM Criteria preferred.
  • Familiarity with Medicaid, commercial insurance, and managed care plans.
  • Strong organizational and time management skills.
  • Excellent verbal and written communication skills.
  • Ability to prioritize multiple cases in a fast-paced environment.
  • Proficient in Microsoft Office and electronic health record systems.
Knowledge, Skills, and Abilities
  • Understanding of insurance authorization processes.
  • Knowledge of medical necessity criteria and documentation standards.
  • Strong analytical and critical thinking skills.
  • Excellent customer service and professional communication.
  • Ability to work independently while collaborating with interdisciplinary teams.
  • Attention to detail and accuracy.
  • Ability to maintain confidentiality.
Performance Expectations
  • Maintain timely insurance authorizations with minimal lapses.
  • Reduce avoidable authorization denials.
  • Ensure documentation meets payer standards.
  • Maintain accurate records and reporting.
  • Demonstrate professionalism, teamwork, and excellent customer service.
  • Comply with all organizational policies, HIPAA, Joint Commission standards, and applicable federal and New Jersey regulations.

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