Behavioral Health Utilization Review Specialist

Leora; Cincinnati (OH); On-site; USD 25,000 - 30,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

Life Insurance

401(k) with Company Match

Paid Time Off

Job summary

Leora Behavioral Health in Blue Ash, OH is seeking a detail-oriented Utilization Review (UR) Coordinator to support timely review actions for behavioral health services. You will work with clinicians, insurers, and internal teams to ensure authorizations are completed accurately and in alignment with payer requirements.

The ideal candidate will be highly organized, comfortable handling confidential information, and experienced with insurance authorizations or related administrative processes.

Qualifications

• High school diploma or equivalent; associate or bachelor's degree in healthcare preferred.
• Experience in healthcare, behavioral health, utilization review, insurance authorizations, or related administrative role.
• Strong organizational and time-management skills.
• Excellent written and verbal communication skills.
• Ability to handle confidential patient and insurance information.
• Proficiency with EHRs, MS Office, and healthcare information systems.

Responsibilities

• Coordinate initial, concurrent, retrospective, and continued-stay UR activities.
• Monitor authorization periods, review dates, and payer deadlines.
• Obtain and maintain insurance eligibility, benefits, authorization, and clinical review information.
• Prepare and submit required documentation to insurers and UR organizations.
• Coordinate clinical information between treating providers and payers while maintaining confidentiality.
• Track authorization requests, determinations, extensions, denials, and appeals.
• Maintain UR records, logs, and documentation.
• Communicate with insurance representatives regarding requirements and status.
• Notify staff of decisions and upcoming deadlines.
• Escalate authorization barriers to clinical or leadership teams.
• Assist with peer-to-peer reviews and appeals when requested.
• Collaborate with admissions, clinical, billing, and revenue-cycle teams.
• Ensure documentation complies with policies, payer requirements, HIPAA.
• Participate in quality-improvement initiatives related to utilization management.
• Perform other duties as assigned.

Skills

Organizational skills

Time-management

Communication skills

Education

High school diploma or equivalent

Associate or Bachelor’s degree preferred

Tools

Electronic Health Records (EHR)

Microsoft Office

Job description

Leora Behavioral Health in Blue Ash, OH is seeking a detail-oriented Utilization Review (UR) Coordinator to support timely review actions for behavioral health services. You will work with clinicians, insurers, and internal teams to ensure authorizations are completed accurately and in alignment with payer requirements.

The ideal candidate will be highly organized, comfortable handling confidential information, and experienced with insurance authorizations or related administrative processes.