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Senior Occupational Therapy Utilization Review Jobs

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 ... with ABA therapy best practices and insurance requirements. * Accurately input and maintain ...

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 ...

UHS

Utilization Review Coordinator

Augusta, GA · On-site

... with physicians, therapist, nurses and pertinent staff on gathering the necessary data to ... utilization review. CERTIFICATIONS, LICENSES, REGISTRATION LMHC, LAPC, LPC, LMSW, LCSW, LPN or RN ...

Boise of Cascadia, LLC

Occupational Therapy

Boise, ID · On-site

$38.25 - $50.50/hr

Contribute to facility patient care, utilization review, case management, administrative staff ... Provides skilled occupational therapy services / interventions in accordance with physician orders.

Boise of Cascadia, LLC

Occupational Therapy

Boise, ID

$38.25 - $50.50/hr

Contribute to facility patient care, utilization review, case management, administrative staff ... Provides skilled occupational therapy services / interventions in accordance with physician orders.

Cascadia of Boise

Occupational Therapy

Boise, ID · On-site

$38.25 - $50.50/hr

Contribute to facility patient care, utilization review, case management, administrative staff ... Provides skilled occupational therapy services / interventions in accordance with physician orders.

UHS

Utilization Review Coordinator

Augusta, GA · On-site

... with physicians, therapist, nurses and pertinent staff on gathering the necessary data to ... utilization review. CERTIFICATIONS, LICENSES, REGISTRATION LMHC, LAPC, LPC, LMSW, LCSW, LPN or RN ...

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Senior Occupational Therapy Utilization Review information

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$51.5K

$74.5K

$111.5K

How much do senior occupational therapy utilization review jobs pay per year?

As of Jul 18, 2026, the average yearly pay for senior occupational therapy utilization review in the United States is $74,494.00, according to ZipRecruiter salary data. Most workers in this role earn between $62,500.00 and $79,500.00 per year, depending on experience, location, and employer.

What is a Senior Occupational Therapy Utilization Review?

A Senior Occupational Therapy Utilization Review professional is responsible for evaluating the medical necessity, appropriateness, and efficiency of occupational therapy services. They review patient records, treatment plans, and clinical documentation to ensure compliance with insurance policies and regulatory standards. This role often involves collaborating with therapists, physicians, and insurance companies to determine the best care options while managing costs. Senior reviewers may also mentor junior staff and contribute to policy development within their organization.

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

AspectSenior Occupational Therapy Utilization ReviewOccupational Therapist
CredentialsLicensed Occupational Therapist, additional experience in utilization reviewLicensed Occupational Therapist
Work EnvironmentUtilization review departments, insurance companies, healthcare organizationsHospitals, clinics, outpatient facilities
Job FocusReviewing medical necessity, insurance authorization, and documentationProviding direct patient care, therapy assessments, treatment planning

The main difference is that Senior Occupational Therapy Utilization Review specialists focus on evaluating treatment necessity and insurance compliance, while Occupational Therapists provide direct patient care and therapy services. The review role emphasizes administrative and evaluative tasks, whereas the therapist role involves hands-on therapy delivery.

What are the key skills and qualifications needed to thrive as a Senior Occupational Therapy Utilization Review specialist, and why are they important?

To thrive as a Senior Occupational Therapy Utilization Review specialist, you need advanced clinical knowledge in occupational therapy, experience in case review, and usually a valid OT license with several years of practice. Familiarity with utilization management software, electronic health records (EHRs), and understanding of insurance guidelines are essential. Excellent analytical thinking, attention to detail, and strong communication skills help in assessing cases and collaborating with providers. Mastering these skills ensures accurate, evidence-based reviews that support quality patient care and compliance with payer policies.

How does a Senior Occupational Therapy Utilization Review specialist typically collaborate with clinicians and case managers to ensure appropriate patient care?

As a Senior Occupational Therapy Utilization Review specialist, you will regularly coordinate with clinicians and case managers to evaluate the medical necessity and appropriateness of occupational therapy services for patients. This involves reviewing clinical documentation, discussing complex cases, and providing education to care teams about coverage criteria and best practices. Collaborating effectively ensures that patients receive timely and necessary therapy while also aligning with payer guidelines. Strong communication and negotiation skills are essential for building positive relationships and facilitating high-quality outcomes.
What cities are hiring for Senior Occupational Therapy Utilization Review jobs? Cities with the most Senior 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 Senior Occupational Therapy Utilization Review jobs? States with the most job openings for Senior Occupational Therapy Utilization Review jobs include:
Senior Occupational Therapy Utilization Review jobs near you

Utilization Review Specialist

ICBD

Lauderdale Lakes, FL • On-site

$55K - $70K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 22 days ago

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. 

We are committed to providing reasonable accommodation for qualified individuals with disabilities throughout the hiring process and employment. If you require assistance or accommodation, please let us know. 

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