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Utilization Review Specialist (Remote)
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- Job DescriptionJob DescriptionUtilization Review Specialist/Behavioral Health Substance AbuseFLSA Status: ExemptClassification: Full-Time Reports To: The UR Specialist will report to UR Manager.
- Job Overview: The Utilization Review Specialist is responsible for all aspects of the authorization of treatment via insurance and managed care companies.
- The Utilization Review Specialist provides appropriate client information to third party payers regarding the medical necessity of treatment in a timely manner.
- The Utilization Review Specialist will also perform pre-certification reviews, concurrent reviews and will perform appeal reviews as needed.
- Knowledge of accreditation and licensure requirements (RN, LCSW, LPN, LMFT) in accordance with state agencies.
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