Utilization Review Coordinator

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🔥 3 minutes ago

⛰️ Colorado – Remote

⛰️ Colorado – Remote

💵 $63k - $85k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

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Foundry Treatment Center Steamboat

WebsiteLinkedInAll Job Openings

11 - 50 employees

Founded 2015

⚕️ Healthcare Insurance

🧘 Wellness

Healthcare Insurance • Wellness • Mental Health

Foundry Treatment Center Steamboat is a comprehensive addiction treatment facility that focuses on addressing substance use disorders and co-occurring mental health issues through trauma-informed care. The center utilizes a holistic approach that emphasizes recovery-oriented lifestyles and self-regulation skills while providing medical, psychiatric, and therapeutic services tailored to individual client needs. With a strong commitment to family involvement and community awareness, Foundry Steamboat aims to improve access to treatment and educate the public about the complexities of addiction and mental health.

📋 Description

• Submit initial and continued stay authorization requests to insurance payors. • Track authorization approvals, denials, and expiration dates. • Maintain accurate and timely documentation in the electronic health record. • Communicate authorization status to clinical and administrative staff. • Assist with gathering clinical information for utilization reviews and audits. • Follow up with insurance companies to ensure timely determinations. • Support peer-to-peer reviews by coordinating required documentation and scheduling. • Identify potential authorization issues and escalate to the Utilization Review Manager as needed. • Ensure compliance with payor requirements, timelines, and internal policies. • Assist with data tracking and reporting related to utilization and denials. • Other duties as assigned.

🎯 Requirements

• Bachelor’s degree required, Master’s degree preferred. • Professional clinical or nursing license strongly preferred (LPC, LCSW, LMFT, LPN, RN). • Experience in utilization review, care coordination, or healthcare administration preferred. • Behavioral health experience strongly preferred. • Knowledge of insurance authorization processes and medical necessity criteria a plus. • Strong organizational and time management skills. • Attention to detail and accuracy. • Ability to manage multiple tasks and deadlines. • Clear and professional communication skills. • Ability to work collaboratively with clinical and administrative teams. • Problem-solving and follow-up skills. • Familiarity with electronic health records and healthcare documentation standards. • Proficient with Google Workspace or related software.

🏖️ Benefits

• Medical, dental and vision insurance* • Supplemental accident and hospital indemnity coverage* • Voluntary Term Life insurance* • Employee Assistance Program • Monthly wellness reimbursement* • Employee recognition and rewards programs • Employee referral incentive program • Employer-sponsored 401(k) plan • Continuing education reimbursement • Unlimited paid time off (exempt employees) + sick days • Paid time off policy (non-exempt employees) + sick days • Paid holidays (exempt) or ability to earn 1.5x base hourly rate (non-exempt) *Full-time employees