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Commission Occupational Therapy Utilization Review Jobs

Sentara Health Plans

UTILIZATION REVIEW NURSE

Norfolk, VA · On-site

$65 - $85/hr

The Utilization Review Nurse is responsible for utilization management services within the scope of ... therapy, outpatient surgery centers, and an 858,000 member health plan. The people of the ...

New

Sentara Health Plans

$65 - $85/hr

The Utilization Review Nurse is responsible for utilization management services within the scope of ... therapy, outpatient surgery centers, and an 858,000 member health plan. The people of the ...

New

PARKSIDE INC

Utilization Review Specialist

Tulsa, OK · On-site

For over 65 years, Parkside's physicians, therapists, and staff have provided state of the art, ... The Utilization Review Specialist asses, plans, implements and evaluates the internal processes to ...

Protouch Staffing

Occupational Therapist

Edgartown, MA · On-site

$47.25 - $62.25/hr

Occupational Therapist (OT) Location : Edgartown, MA Full-Time & Part time Typical hours: Monday ... Monitor therapy utilization to ensure appropriate and effective service delivery. Leadership ...

UHS

Utilization Review Clinician

Augusta, GA · On-site

Website: The Utilization Review Clinician opportunity is a key member of the Lighthouse Case ... LMHC, LMFT, LAPC, LPC, LMSW, LCSW, LPN or RN preferred EEO Statement: All UHS subsidiaries are ...

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Commission Occupational Therapy Utilization Review information

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$23

$45

$67

How much do commission occupational therapy utilization review jobs pay per hour?

As of Sep 2, 2026, the average hourly pay for commission occupational therapy utilization review in the United States is $45.37, according to ZipRecruiter salary data. Most workers in this role earn between $38.70 and $50.96 per hour, depending on experience, location, and employer.

What is the difference between Commission Occupational Therapy Utilization Review vs Occupational Therapist?

AspectCommission Occupational Therapy Utilization ReviewOccupational Therapist
CredentialsLicensed occupational therapists with additional training in utilization reviewLicensed occupational therapists
Work EnvironmentInsurance companies, healthcare organizations, utilization review departmentsHospitals, clinics, outpatient facilities, schools
Primary FocusReviewing medical necessity and appropriateness of occupational therapy servicesProviding direct occupational therapy services to patients

The main difference is that Commission Occupational Therapy Utilization Review specialists focus on evaluating the necessity of therapy services, often working within insurance or healthcare organizations, while Occupational Therapists provide direct patient care. Both roles require occupational therapy credentials, but their work environments and responsibilities differ significantly.

What cities are hiring for Commission Occupational Therapy Utilization Review jobs?

Cities with the most Commission Occupational Therapy Utilization Review job openings:

What are the most commonly searched types of Occupational Therapy Utilization Review jobs?

The most popular types of Occupational Therapy Utilization Review jobs are:

What states have the most Commission Occupational Therapy Utilization Review jobs?

States with the most job openings for Commission Occupational Therapy Utilization Review jobs include:

Commission Occupational Therapy Utilization Review jobs near you

Utilization Review

Discovery Institute of Addictive Disorders Inc.

Marlboro, NJ • On-site

Full-time

Re-posted 8 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.