Behavioral Health Utilization Review Specialist

Managing insurance authorizations for mental health and substance use treatment, the full-time Behavioral Health Utilization Review Specialist will verify benefits, complete prior authorizations, and support medical necessity criteria while working remotely. Key responsibilities Verify insurance benefits, eligibility, and coverage requirements Complete prior authorizations, pre-certifications, and concurrent reviews Collaborate with clinical teams to support continuity of care Required qualifications 2+ years of PHP/IOP utilization review or insurance authorization experience Knowledge of ASAM, LOCUS, CALOCUS, and medical necessity standards Experience communicating with insurance payers and managed care organizations Proficiency with EMR/EHR platforms and authorization software Eligibility for DCF and AHCA Level 2 background screening