Utilization Review Coordinator

🔥 12 hours ago

🥔 Idaho – Remote

🥔 Idaho – Remote

💵 $20 - $25 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 0%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Northpoint Recovery

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 2014

🏥 Healthcare

Healthcare • Mental Health • Addiction Treatment

Northpoint Recovery is a comprehensive addiction treatment center located in Boise, Idaho, offering a range of services for adults and teens struggling with substance use disorders and co-occurring mental health issues. They provide tailored inpatient and outpatient programs that include detox, individual therapy, and evidence-based treatments like cognitive behavioral therapy, all designed to support lasting recovery and relapse prevention. With a focus on compassionate care and a therapeutic environment, Northpoint Recovery aims to help clients build healthier futures and achieve sobriety.

📋 Description

• Monitor authorization work queues, fax queues, and tracking tools for pending, approved, denied, and expiring authorizations • Track authorization dates, approved units/days, expiration dates, payer reference numbers, and other required authorization information • Identify upcoming authorization expirations and communicate deadlines or outstanding requirements to UR Specialists • Coordinate collection and submission of payer-requested clinical documentation, including progress notes, treatment plans, assessments, discharge summaries, and other records • Upload, fax, electronically transmit, or submit clinical documentation through payer portals and verify successful receipts • Perform routine payer follow-up regarding authorization status, documentation receipt, outstanding requests, and administrative requirements • Support UR Specialists in preparing and organizing documentation for initial and concurrent authorization reviews • Assist with payer portal activity, authorization verification, and non-clinical payer communication • Maintain authorization information, payer correspondence, and supporting documentation in KIPU and designated systems • Coordinate administrative requirements for peer-to-peer reviews, payer escalations, and authorization appeals • Support discharge-related UR documentation and discharge summaries of authorization records • Maintain payer reference materials, authorization requirements, workflows, and departmental resources • Assist with UR standard operating procedures, payer guides, workflows, and training materials • Provide cross-market support based on authorization volume, staffing needs, and departmental priorities • Partner with Clinical Operations, Admissions, Billing, and other RCM functions to resolve authorization issues and ensure continuity of information • Participate in departmental meetings, training, payer education, and process-improvement initiatives • Maintain patient confidentiality and comply with HIPAA, organizational policies, payer requirements, and regulatory standards • Perform other duties as assigned to support Utilization Review and Revenue Cycle Management

🎯 Requirements

• High school diploma or equivalent required • Previous experience in behavioral health, healthcare administration, utilization management, revenue cycle management, insurance verification, medical billing, payer authorization, or a related healthcare environment preferred • Experience working with commercial insurance, Medicaid, Medicare, or managed-care organizations preferred • Familiarity with behavioral health levels of care, including residential, PHP, IOP, and outpatient services, preferred • Experience with electronic medical records, payer portals, and healthcare revenue-cycle systems preferred • Experience with KIPU or similar behavioral-health EMR platforms is a plus • Strong organizational and time-management skills with the ability to manage multiple deadlines simultaneously • Exceptional attention to detail and accuracy • Ability to identify time-sensitive authorization issues and appropriately escalate concerns • Strong written and verbal communication skills • Ability to communicate professionally with payers and internal stakeholders • Working knowledge of healthcare insurance terminology, authorizations, medical necessity, and payer requirements • Ability to learn and interpret payer-specific authorization requirements • Strong computer skills and ability to work across multiple systems, payer portals, and tracking tools • Ability to maintain accurate documentation and detailed records • Strong problem-solving skills and willingness to independently research routine issues before escalation • Ability to work collaboratively in a fast-paced, multi-market environment • Demonstrated professionalism and discretion when handling confidential patient and organizational information • Ability to work Monday-Friday, 8am-5pm

🏖️ Benefits

• Subsidized Health Insurance Coverage for Employee, Spouse, & Dependent(s) • 100% Employer Paid Basic Life Insurance equal to 1x annual salary, up to $100,000 • 100% Employer Paid Employee Assistance Program • Voluntary Dental, Vision, Short-Term Disability, Supplemental Life & AD&D, Critical Illness, Accident, and Hospital Indemnity Insurance • Pre-tax Savings Accounts for all IRS-allowable medical and dependent care expenses • Generous Paid Time Off plan • Employee Referral Bonuses • 401K Retirement Plan & Employer Match • Remote work arrangement

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