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Therapy Utilization Review Jobs (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 ... with ABA therapy best practices and insurance requirements. * Accurately input and maintain ...

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 ...

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

... 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 ...

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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Therapy Utilization Review information

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How much do therapy utilization review jobs pay per hour?

As of Jul 7, 2026, the average hourly pay for therapy utilization review in the United States is $31.94, according to ZipRecruiter salary data. Most workers in this role earn between $22.36 and $40.62 per hour, depending on experience, location, and employer.

What is the difference between Therapy Utilization Review vs Speech-Language Pathologist?

AspectTherapy Utilization ReviewSpeech-Language Pathologist
CredentialsTypically requires healthcare or insurance-related certificationsRequires a master's degree in speech-language pathology and state licensure
Work EnvironmentInsurance companies, healthcare organizations, or utilization review departmentsHospitals, clinics, schools, or private practice
Industry UsageFocuses on evaluating therapy necessity and coverageProvides direct therapy services to patients with speech or language disorders

While Therapy Utilization Review involves assessing the necessity of therapy services for insurance coverage, Speech-Language Pathologists provide direct patient care. Both roles require healthcare knowledge, but they differ in focus: one is review-based, the other is clinical service delivery.

What are some common challenges faced by professionals in Therapy Utilization Review, and how can they be managed?

One of the main challenges in Therapy Utilization Review is balancing the clinical needs of patients with insurance guidelines and organizational policies. Professionals often need to make difficult decisions about treatment approvals while communicating effectively with both therapists and insurance providers. Staying current on clinical guidelines, maintaining strong documentation skills, and developing firm but empathetic communication abilities can help manage these challenges. Collaboration with interdisciplinary teams is also essential to ensure patients receive appropriate care while meeting regulatory requirements.

What is Therapy Utilization Review?

Therapy Utilization Review is a process used by healthcare organizations and insurance companies to evaluate the necessity, efficiency, and appropriateness of therapy services being provided to patients. This review ensures that treatments such as physical, occupational, or speech therapy are medically necessary and align with established guidelines. The goal is to optimize patient care while managing costs and preventing overuse or misuse of therapy services. Professionals in this role review patient records, treatment plans, and progress notes, often collaborating with therapists and other healthcare providers.

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

To thrive as a Therapy Utilization Review specialist, you need a solid background in clinical therapy practice (such as physical, occupational, or speech therapy), often supported by licensure and clinical experience. Familiarity with medical review software, electronic health records (EHRs), and utilization management systems is typically required, along with knowledge of insurance guidelines and regulatory standards. Strong analytical thinking, attention to detail, and clear communication skills help professionals effectively assess treatment plans and collaborate with both providers and payers. These skills and qualities are essential for ensuring that patients receive medically necessary, cost-effective therapy while maintaining compliance with regulations.
More about Therapy Utilization Review jobs
What cities are hiring for Therapy Utilization Review jobs? Cities with the most Therapy Utilization Review job openings:
What states have the most Therapy Utilization Review jobs? States with the most job openings for Therapy Utilization Review jobs include:
What job categories do people searching Therapy Utilization Review jobs look for? The top searched job categories for Therapy Utilization Review jobs are:
Therapy Utilization Review jobs near you
Infographic showing various Therapy Utilization Review job openings in the United States as of July 2026, with employment types broken down into 1% As Needed, 80% Full Time, 15% Part Time, 1% Temporary, and 3% Contract. Highlights an 91% Physical, 2% Hybrid, and 7% Remote job distribution, with an average salary of $66,436 per year, or $31.9 per hour.
Utilization Review Specialist

Utilization Review Specialist

Northlake Behavioral Health System

Mandeville, LA • On-site

Full-time

Posted 26 days ago

Job description

Position: Utilization Review Specialist

Status: Full Time, Days

Schedule: Mon-Fri, Days. New hire will have the option to choose a schedule of either 7:30am to 4:00pm or 8:00am to 4:30pm.
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 they need — and that our facility is appropriately reimbursed for the services we provide.

In this role, you'll conduct admission, concurrent, and continued stay reviews with managed care organizations, commercial insurers, and government payers. You'll work closely with psychiatrists, nurses, therapists, and case managers to make sure clinical documentation supports medical necessity, and you'll manage denials and appeals to protect both patient access and reimbursement.

What You'll Do

Utilization Review & Authorizations

  • Conduct admission, concurrent, and continued stay reviews for inpatient behavioral health patients

  • Evaluate patient records against payer medical necessity and level-of-care criteria

  • Complete telephonic and electronic reviews with managed care organizations and third-party payers

  • Secure initial and continued stay authorizations; track authorization periods and obtain extensions

  • Submit clinical information on time to prevent authorization lapses and reimbursement delays

Denials & Appeals

  • Review denials and coordinate reconsiderations, peer-to-peer reviews, and appeals

  • Prepare appeal packets with supporting clinical documentation

  • Monitor denial trends and identify ways to improve authorization outcomes

Clinical Documentation & Team Collaboration

  • Review psychiatric, nursing, and therapy documentation for accuracy and medical necessity support

  • Coach providers and clinical staff on documentation improvements

  • Participate in treatment team discussions to support medical necessity and discharge planning

  • Serve as the go-to resource on behavioral health payer criteria and UR processes

Data & Compliance

  • Maintain authorization, denial, and appeal tracking logs with timely, accurate data entry

  • Assist with audits, reporting, and performance improvement initiatives

  • Maintain compliance with federal/state regulations, accreditation standards, and HIPAA

What We're Looking For

Required:

  • Associate's degree in healthcare related field — OR a high school diploma/GED with at least 4 years of psychiatric, behavioral health, utilization review, case management, admissions, or related healthcare experience

  • Min 2 years of experience in a psychiatric, behavioral health, or healthcare setting

  • Knowledge of managed care, medical necessity criteria, utilization review, third-party reimbursement, and clinical documentation review

  • Strong organization and time management — you'll juggle multiple payer reviews and deadlines

Ready to apply? Submit your resume today

Northlake Behavioral Health is an equal opportunity/affirmative action employer. All qualified applicants are encouraged to apply and will receive consideration for all employment; free from discrimination based on race, creed, color, national origin, age, sex, pregnancy, sexual orientation, gender identity, genetic information, religion, associational preferences, status as a qualified individual with a disability, or status as a protected veteran.