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Utilization Review Administrative Assistant Jobs

Discovery Institute NJ

Utilization Review

Marlboro, NJ · On-site

Monitor payer portals for authorization updates. * Assist with Medicaid and managed care authorization processes. * Participate in utilization review meetings and case conferences. * Generate reports ...

RECAP INC

Utilization Review Specialist

Middletown, NY · On-site

$27 - $34/hr

Collaborate with clinical, medical, and administrative staff to ensure treatment plans and ... * Assist clinicians in strengthening documentation and provide feedback on best practices.

Tampa General Hospital

Under the administrative supervision of the Director of Utilization Management, manages the daily ... assist hospital leadership in identifying opportunities for improvement. Develops effective ...

New

Acrisure, LLC

Complete required documentation and administrative processing throughout the utilization review process* Manage assigned reviews within applicable state-mandated and URAC turnaround requirements*

Acrisure

Utilization Review Nurse

Bradenton, FL · On-site

Complete required documentation and administrative processing throughout the utilization review process * Manage assigned reviews within applicable state-mandated and URAC turnaround requirements

Acrisure, LLC

Utilization Review Nurse

Bradenton, FL · On-site

Complete required documentation and administrative processing throughout the utilization review process* Manage assigned reviews within applicable state-mandated and URAC turnaround requirements*

Acrisure

Utilization Review Nurse

Bradenton, FL

Complete required documentation and administrative processing throughout the utilization review process * Manage assigned reviews within applicable state-mandated and URAC turnaround requirements

Acrisure LLC

Utilization Review Nurse

Bradenton, FL · On-site

Complete required documentation and administrative processing throughout the utilization review process * Manage assigned reviews within applicable state-mandated and URAC turnaround requirements

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Utilization Review Administrative Assistant information

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How much do utilization review administrative assistant jobs pay per hour?

As of Sep 13, 2026, the average hourly pay for utilization review administrative assistant in the United States is $21.04, according to ZipRecruiter salary data. Most workers in this role earn between $17.31 and $23.32 per hour, depending on experience, location, and employer.

What does a utilization review administrative assistant do?

A Utilization Review Administrative Assistant supports the utilization review team by handling administrative tasks related to patient care authorization and insurance verification. They assist with preparing and maintaining records, submitting necessary documentation to insurance companies, and communicating with healthcare providers about patient cases. Their role ensures that all paperwork and processes comply with healthcare regulations, helping to facilitate efficient reviews and approvals for patient services.

What skills and qualifications are needed to be a utilization review administrative assistant?

To thrive as a Utilization Review Administrative Assistant, you need strong organizational skills, attention to detail, and familiarity with healthcare terminology, typically supported by a high school diploma or associate degree. Proficiency with medical records systems, Microsoft Office Suite, and utilization review software is commonly required. Excellent communication, multitasking, and problem-solving abilities help you coordinate efficiently with clinical staff and insurance providers. These skills are crucial for ensuring accurate documentation, effective case management, and compliance with healthcare regulations.

How does a utilization review administrative assistant contribute to the utilization review process?

A Utilization Review Administrative Assistant plays a key role by managing documentation, scheduling case reviews, and ensuring that all necessary medical records are accurately prepared and available for the clinical review team. They coordinate communication between providers, insurance companies, and internal staff, which helps streamline the approval process for medical services. By handling these administrative tasks efficiently, they enable clinicians to focus on making timely, informed decisions, directly impacting the overall workflow and patient care outcomes.

How do I get into a utilization review administrative assistant?

To become a utilization review administrative assistant, candidates typically need a high school diploma or equivalent, along with strong organizational and communication skills. Relevant experience in healthcare or administrative roles, familiarity with medical terminology, and proficiency in office software can improve job prospects; some positions may also require certification in healthcare administration or utilization review processes.

What cities are hiring for Utilization Review Administrative Assistant jobs?

Cities with the most Utilization Review Administrative Assistant job openings:

What states have the most Utilization Review Administrative Assistant jobs?

States with the most job openings for Utilization Review Administrative Assistant jobs include:

What are popular job titles related to Utilization Review Administrative Assistant jobs?

For Utilization Review Administrative Assistant jobs, the most frequently searched job titles are:

Infographic showing various Utilization Review Administrative Assistant job openings in the United States as of September 2026, with employment types broken down into 1% As Needed, 81% Full Time, 16% Part Time, and 2% Contract. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution, with an average salary of $43,768 per year, or $21 per hour.

Utilization Review

Marlboro, NJ • On-site

Discovery Institute NJ
See more jobs at Discovery Institute NJexternal

Other

Re-posted 22 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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