Behavioral Health Utilization Review Coordinator

Sanctuary Recovery Centers Inc; Phoenix (AZ); On-site; USD 33,062 - 39,950; Full time

Job summary

Sanctuary Recovery Centers Inc seeks a detail-oriented Utilization Review (UR) Coordinator / Authorization Representative with clinical experience. This in-office role manages authorizations, ensures medical necessity documentation, and maintains AHCCCS compliance.

Ideal candidates will have behavioral health utilization management knowledge, experience handling high caseloads, and strong attention to regulatory filing timelines.

Qualifications

• :2+ years in utilization review, authorizations, or behavioral health administration
• Clinical experience to aid review of medical necessity
• Strong knowledge of AHCCCS requirements and guidelines
• Experience with payer-specific timely filing requirements
• Ability to manage high caseloads in fast-paced environments
• Familiarity with behavioral health levels of care (RTC, PHP, IOP)
• Excellent organizational and communication skills
• Experience with authorization tracking tools and documentation

Responsibilities

• Obtain, track, and manage initial and concurrent authorizations for behavioral health services.
• Coordinate and complete utilization review processes in compliance with AHCCCS guidelines and medical necessity criteria.
• Submit timely and accurate authorization requests, ensuring adherence to payer-specific timely filing requirements.
• Monitor authorizations for expiration and proactively manage concurrent reviews to prevent gaps in coverage.
• Communicate effectively with clinical staff, payers, and case managers to gather necessary documentation and ensure continuity of care.
• Maintain accurate and up-to-date records in the EHR and authorization tracking systems.
• Review clinical documentation for completeness and alignment with medical necessity standards.
• Manage a high volume of client cases, prioritizing tasks to meet deadlines and avoid service disruptions.
• Follow up on pending authorizations, denials, and appeals as needed.
• Ensure compliance with all federal, state, and AHCCCS regulations, as well as internal policies and procedures.

Skills

Utilization Review

Regulatory compliance

Healthcare documentation

Payer guidelines

High caseload management

Communication

EHR proficiency

Independent & team work

Attention to detail

HIPAA confidentiality

Tools

EHR systems

Job description

Sanctuary Recovery Centers Inc seeks a detail-oriented Utilization Review (UR) Coordinator / Authorization Representative with clinical experience. This in-office role manages authorizations, ensures medical necessity documentation, and maintains AHCCCS compliance.

Ideal candidates will have behavioral health utilization management knowledge, experience handling high caseloads, and strong attention to regulatory filing timelines.