ABA Utilization Review (UR) Specialist

Santa Barbara Cottage Hospital; United States; Hybrid; USD 60,000 - 80,000; Full time

Benefits offered by this job

Flexible work environment

Competitive Salary

Growth opportunities

Medical, Dental, Vision benefits

401K with Company match

Flexible Paid Time Off

Supplemental Benefits

Job summary

Santa Barbara Cottage Hospital is looking for an ABA Utilization Review Specialist to join their team. This role focuses on reviewing clinical information and obtaining authorizations for ABA services. The position can be fully remote or hybrid, offering a flexible work environment.

The ideal candidate will have 3-5 years of experience in ABA or Behavioral Health and must possess excellent communication skills. Competitive salary and benefits package, including medical, dental, and 401K match, are offered.

Qualifications

• 3-5 years of related ABA and/or Behavioral Health experience.
• Ability to work independently and within a team.
• Solid understanding of insurance benefits and coverages.

Responsibilities

• Review patient admission and clinical information for compliance.
• Obtain initial and continuing authorization for treatment services.
• Document all necessary information and track authorization cases.

Skills

Behavioral Health experience

Written and oral communication skills

Attention to detail

Teamwork skills

Multi-tasking

Computer skills

Education

Bachelor’s or master’s degree

Tools

Word

Excel

Billing software

Job description

Overview

Spectrum Billing Solutions offers industry-leading revenue cycle management services for healthcare providers. Our team has deep industry knowledge, technology, and experience to ensure our client’s revenue cycle is managed in the most efficient and streamlined manner.

We are seeking to add an ABA Utilization Review (UR) Specialist to our growing team. The ABA UR Specialist will utilize his or her knowledge and skills to review clinical information and obtain initial and continuing authorizations for ABA and related services. The ideal candidate is passionate, motivated, detail-oriented and interested in working in a cohesive and rewarding environment.

This is a fully remote or office/home hybrid position.

Responsibilities

• Review patient admission and clinical information to ensure medical necessity and compliance of utilization review guidelines.
• Obtain initial and continuing authorization for treatment services.
• Manage authorization denials including referral for peer review.
• Document and record all necessary information.
• Monitor and track new and ongoing authorization cases.
• Collaborate and communicate with clinical staff to ensure necessary information is obtained and timely reviews are performed.
• Assist external clients in understanding payer requirements for authorizations.
• Participate in team meetings.
• Maintain confidentiality of patient information and adhere to HIPAA regulations.

What we offer you

• Flexible work environment
• Competitive Salary
• A close-knit team of talented and skilled individuals.
• Growth opportunities
• Benefits – Medical, Dental, Vision
• Flexible Paid Time Off
• 401K with Company match
• Supplemental Benefits

Qualifications

• 3-5 years of related ABA and/or Behavioral Health experience.
• Bachelor’s or master’s degree preferred.
• Superior written and oral communication skills
• Attention to detail to ensure necessary information is captured and properly documented.
• Ability to work independently and within a team.
• Ability to multi-task, prioritize and meet expected deadlines.
• Solid understanding of insurance benefits and coverages.
• Strong computer skills (Word, Excel, billing software).
• Understanding of mental and behavioral health treatment services.