Utilization Review Coordinator – Behavioral Health
Avenues Recovery Center is a nationwide network of drug and alcohol rehabilitation centers with eighteen locations across seven states. We provide highly individualized, evidence-based treatment in clean, modern settings across all levels of care including detox, residential, PHP, IOP, and outpatient services.
About the role
The Utilization Review Specialist ensures timely authorization of client services, supports appropriate level-of-care determinations, and partners closely with clinical and billing teams to maintain accurate documentation and continuity of care across facilities. This role requires strong communication, attention to detail, and the ability to collaborate across clinical, administrative, and billing departments.
Responsibilities
- Utilization Review & Authorization Management
- Field incoming calls, emails, and documentation requests related to client authorizations
- Ensure timely approval and continuation of services at the appropriate level of care
- Manage client caseloads and support authorization workflows across facilities
- Advocate for continued stay based on clinical documentation and treatment needs
- Clinical & Billing Collaboration
- Work closely with billing and clinical teams to identify and resolve authorization issues
- Communicate with facility leadership regarding UR status and documentation needs
- Support coordination between treatment teams and administrative departments
- Documentation & Compliance
- Maintain accurate electronic records of all UR activity and authorization communications
- Ensure documentation meets internal standards and payer requirements
- Assist in identifying gaps in charting and supporting improvements in documentation workflows
- Systems & Process Improvement
- Assist in creating standardized templates and UR workflows across facilities
- Work with site leaders to ensure consistent implementation of processes
- Support improvement of internal UR systems and efficiency initiatives
Requirements
- Education
- High school diploma or GED required
- Bachelor's degree preferred
- Nursing background, clinical background or healthcare knowledge strongly preferred
- Experience
- Minimum 1 year of experience in behavioral health, healthcare, or treatment setting preferred
- Experience with utilization review, insurance authorization, or medical billing strongly preferred
Skills
- Strong communication (written and verbal)
- Excellent interpersonal and collaboration skills
- Strong attention to detail and documentation accuracy
- Ability to manage multiple cases and deadlines
- Sound judgment and critical thinking
- Flexible, team-oriented, and adaptable in a fast-paced environment
- Willing to train
Benefits
- 401(k) with employer match
- Medical, Dental, and Vision Insurance
- Accident, Critical Illness, and Hospital Indemnity coverage
- Employer-paid Life and AD&D Insurance
- Short- and Long-Term Disability options
- Legal coverage and Identity Theft Protection
- Pet Insurance
- Employee Assistance Program (EAP)
- Flexible Spending Accounts (Medical & Dependent Care)
Schedule
Full-time
Location: Corporate office - New Jersey