Remote Utilization Review Coordinator — Addiction Treatment

Default MnTC Brand; Minneapolis (MN); Hybrid; USD 37,000 - 41,000; Full time

Job summary

Minnesota Adult & Teen Challenge is seeking an Utilization Review Coordinator in Minneapolis, MN, to obtain and maintain insurance authorizations for treatment services. You will partner with admissions, counselors, and payers to ensure timely authorizations, support medical necessity determinations, and promote compliance with payer and regulatory requirements.

The role emphasizes collaboration, documentation accuracy, and continuous improvement in utilization review processes, with a path from

Qualifications

• High school diploma or GED required; higher degree preferred.
• Two years of utilization review, admissions, or related healthcare experience required.
• Licensed Alcohol and Drug Counselor (LADC) credentials preferred but not required.
• Experience in substance use disorder treatment or behavioral healthcare preferred.
• Knowledge of DSM-5-TR, ASAM Criteria, and payer requirements preferred.
• Experience using EMR systems, preferably Credible or similar.

Responsibilities

• Obtain and maintain insurance authorizations for treatment services.
• Submit initial approvals, continued stay reviews, and reauthorizations on time.
• Monitor status and renewals to prevent care interruptions.
• Communicate determinations and payer requirements to clinical teams.
• Collaborate with staff to support medical necessity and level of care decisions.
• Review documentation for payer alignment and regulatory compliance.
• Assist with denial management, appeals, and information requests.
• Maintain HIPAA and 42 CFR Part 2 compliance in all activities.

Skills

Organizational skills

Time management

Communication

Problem-solving

Collaboration

Education

High school diploma or GED

Associate's or Bachelor's degree preferred

Tools

Credible EMR

Job description

Minnesota Adult & Teen Challenge is seeking an Utilization Review Coordinator in Minneapolis, MN, to obtain and maintain insurance authorizations for treatment services. You will partner with admissions, counselors, and payers to ensure timely authorizations, support medical necessity determinations, and promote compliance with payer and regulatory requirements.

The role emphasizes collaboration, documentation accuracy, and continuous improvement in utilization review processes, with a path from