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Utilization Review Coordinator

Utilization Review Coordinator

Your Behavioral HealthTorrance, CA, US
30+ days ago
Job type
  • Full-time
Job description

About Us :

Your Behavioral Health is dedicated to providing exceptional, evidence-based mental health and addiction treatment through Clear Behavioral Health and Neuro Wellness Spa. Our UR team plays a vital role in ensuring clients receive timely and medically necessary care.

Position Overview :

We are seeking a detail-oriented, proactive Utilization Review (UR) Coordinator to support insurance authorization processes across all levels of care — including Detox, Residential, PHP, IOP — as well as Transcranial Magnetic Stimulation (TMS) services. The UR Coordinator will collaborate closely with clinical teams and payors to advocate for clients, secure appropriate insurance authorizations, and support a smooth treatment experience.

Key Responsibilities :

Insurance Authorizations :

  • Obtain initial and concurrent authorizations for Detox, Residential, PHP, and IOP programs
  • Obtain TMS service authorizations for Neuro Wellness Spa
  • Conduct clinical reviews and advocate with commercial health plans to support medically necessary care
  • Track authorization timelines and follow up promptly on outstanding requests

Documentation & Systems :

  • Maintain accurate, real-time records of authorization activity
  • Gather and review clinical documentation to support authorization requests
  • Document all communications with payors clearly and thoroughly

    • Collaboration & Communication :

  • Communicate regularly with insurance representatives, clinical teams, and leadership about authorization status and updates
  • Work collaboratively with the UR team to improve processes and enhance coordination of care

    • Denials & Appeals Support :

  • Assist with denial management, support appeal efforts with case summaries and clinical data
  • Help identify trends in authorization delays or denials and provide input to leadership

    • Other Duties :

  • Perform other responsibilities as assigned to support team goals and company needs

    • Qualifications :

  • 1–2 years of utilization review experience, preferably in behavioral health or mental health settings
  • Experience obtaining Detox, Residential, PHP, and IOP authorizations with commercial payors
  • Familiarity with TMS treatment and authorization processes
  • Experience with commercial health plans and payor authorization protocols
  • Proficiency with EMR systems, Microsoft Word, and Excel
  • Strong written and verbal communication skills
  • Ability to multitask, prioritize, and work efficiently in a fast-paced environment
  • Professional, collaborative, and passionate about patient advocacy

    • Why Join Us?

  • Your Behavioral Health offers a supportive, collaborative work environment where your contributions truly matter. Join our team and help us advocate for access to high-quality mental health care!
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    Utilization Review Coordinator • Torrance, CA, US

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