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Therapy 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 ... 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 ...

UHS

UR COORDINATOR - Part Time

Titusville, FL

... or utilization review, psychiatric or mental health setting required. Certification: Current, Valid State License (RN, LCSW, LMHC, or LMFT) Preferred. EEO Statement - All UHS subsidiaries are ...

UHS

UR COORDINATOR - Part Time

Titusville, FL · On-site

... or utilization review, psychiatric or mental health setting required. Certification: Current, Valid State License (RN, LCSW, LMHC, or LMFT) Preferred. EEO Statement - All UHS subsidiaries are ...

ICBD

Case Review Analyst

Lauderdale Lakes, FL · On-site

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 ...

ICBD

Case Review Analyst

Fort Lauderdale, FL · On-site

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 ...

ICBD

Case Review Analyst

Lauderdale Lakes, FL

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 ...

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Therapy Utilization Review information

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.

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 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 popular job titles related to Therapy Utilization Review jobs in Florida? For Therapy Utilization Review jobs in Florida, the most frequently searched job titles are:
What job categories do people searching Therapy Utilization Review jobs in Florida look for? The top searched job categories for Therapy Utilization Review jobs in Florida are:
What cities in Florida are hiring for Therapy Utilization Review jobs? Cities in Florida with the most Therapy Utilization Review job openings:
Therapy Utilization Review jobs near you
Infographic showing various Therapy Utilization Review job openings in Florida as of May 2026, with employment types broken down into 91% Full Time, and 9% Part Time. Highlights an 86% Physical, 5% Hybrid, and 9% 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.

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