Utilization Review Coordinator

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 Schedule M-F (fully on-site). #J-18808-Ljbffr