Utilization Review Coordinator

The role

The Utilization Review Coordinator supports the Utilization Review function by coordinating administrative and operational components of the authorization process. This role provides direct support to Utilization Review Specialists through authorization tracking, payer correspondence, and clinical documentation coordination.

What you will do

• Monitor authorization work queues, fax queues, and tracking tools.
• Track authorization dates, approved units, expiration dates, and payer reference numbers.
• Identify upcoming authorization expirations and communicate deadlines to UR Specialists.
• Coordinate collection and submission of clinical documentation like progress notes and treatment plans.
• Upload, fax, and submit clinical documentation through payer portals.
• Perform routine payer follow-up regarding authorization status and documentation receipt.
• Support UR Specialists in preparing documentation for initial and concurrent reviews.
• Assist with payer portal activity and authorization status verification.
• Maintain authorization information and payer correspondence within KIPU and other systems.
• Coordinate administrative requirements for peer-to-peer reviews, payer escalations, and appeals.

Required qualifications

• High school diploma or equivalent

Nice to have

• Associate or bachelor’s degree in healthcare administration, behavioral health, business administration, health information management, or related field
• Previous experience in behavioral health, healthcare administration, utilization management, revenue cycle management, insurance verification, medical billing, payer authorization, or a related health
• Experience working with commercial insurance, Medicaid, Medicare, or managed-care organizations
• Familiarity with behavioral health levels of care, including residential, PHP, IOP, and outpatient services
• Experience with electronic medical records, payer portals, and healthcare revenue-cycle systems
• Experience with KIPU or similar behavioral-health EMR platforms

Benefits

• Subsidized Health Insurance Coverage for Employee, Spouse, & Dependent(s)
• 100% Employer Paid Basic Life Insurance equal to 1x annual salary, up to $100,000
• 100% Employer Paid Employee Assistance Program
• Voluntary Dental, Vision, Short-Term Disability, Supplemental Life & AD&D, Critical Illness, Accident, and Hospital Indemnity Insurance
• Pre-tax Savings Accounts for all IRS-allowable medical and dependent care expenses
• Generous Paid Time Off plan
• Employee Referral Bonuses
• 401K Retirement Plan & Employer Match

About the company

Northpoint Recovery Holdings, LLC is a leading behavioral healthcare provider offering evidence-based treatment for adults with substance use and co-occurring disorders and mental health treatment for adolescents.