ABA Utilization Review (UR) Specialist

Your Responsibilities

• Review patient admission and clinical information to ensure medical necessity and compliance of utilization review guidelines.
• Obtain initial and continuing authorization for treatment services.
• Manage authorization denials including referral for peer review.
• Document and record all necessary information.
• Maintain authorization cases.
• Collaborate and communicate with clinical staff to ensure necessary information is obtained and timely reviews are performed.
• Aid external clients in understanding payer requirements for authorizations.
• Participate in team meetings.

Qualifications

• 3-5 years of related ABA and/or Behavioral Health experience.
• Bachelor’s or master’s degree preferred.
• Superior written and oral communication skills.
• Attention to detail to ensure necessary information is captured and properly documented.
• Ability to work independently and within a team.
• Ability to multi-task, prioritize and meet expected deadlines.
• Solid understanding of insurance benefits and coverages.
• Strong computer skills (Word, Excel, billing software).
• Understanding of mental and behavioral health treatment services.

Pay

Competitive Salary

Schedule

Fully remote or office/home hybrid position.

Benefits

• Medical
• Dental
• Vision
• Flexible Paid Time Off
• 401K with Company match
• Supplemental Benefits