Behavioral Health Utilization / Authorization Specialist

Job Description

Job Description

Behavioral Health Utilization / Authorization Specialist

Location : Sandy, Utah

Schedule : Full-time (40 hours / week, on-site)

Salary : $40,000 – $52,000 (based on experience)

About Us

Threshold Billing Solutions provides specialized claims processing and utilization management services for behavioral health treatment facilities. We work closely with providers, insurers, and managed care organizations to ensure clients receive the highest level of care supported by clinical necessity and payer requirements.

Position Summary

The Utilization / Authorization Specialist plays a key role in advocating for clients by obtaining treatment authorizations and facilitating communication between providers and insurance payers. This position is responsible for reviewing clinical documentation, submitting authorization requests, and ensuring accurate, timely tracking of coverage. The ideal candidate will be detail-oriented, organized, and capable of communicating clearly with both internal teams and external insurance representatives.

Experience in Utilization Review Not Required

While prior utilization review experience is always valued, many of our most successful team members have come from a variety of backgrounds within the behavioral health treatment field. Candidates who have worked in residential treatment centers, outpatient programs, or other clinical / administrative behavioral health settings often transition very well into this role. Their firsthand understanding of the treatment process, client needs, and clinical workflows provides an excellent foundation for learning utilization review.

We provide comprehensive training and ongoing support , so if you bring a strong work ethic, attention to detail, and a passion for supporting access to care, you can thrive with us—even without previous UR experience.

Key Responsibilities

• Maintain proactive and effective communication with insurance payers and managed care organizations.
• Review and interpret clinical documentation, case notes, and assessments to determine and advocate for the appropriate level of care.
• Prepare and submit initial and concurrent authorization requests, as well as appeals when necessary.
• Enter and update authorization details in internal data systems accurately and promptly.
• Track ongoing authorization needs across all levels of care (RTC, PHP, IOP, OP).
• Communicate with facility staff and internal departments regarding client coverage and clinical needs.
• Serve as a client advocate, ensuring access to appropriate care through effective payer communication.
• Ensure timely documentation of all authorizations, decisions, and payer communications.
• Perform other related duties as assigned.

Qualifications

Education & Experience

Benefits

Work Environment

To Apply : Please submit your resume and a brief cover letter detailing your interest in the role and relevant experience.

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