Remote Utilization Review & RCM Coordinator

Sheridan Grove Recovery; Aurora (CO); Hybrid; USD 60,000 - 80,000; Full time

Job summary

Sheridan Grove Recovery is seeking a motivated Utilization Review Coordinator to secure and maintain payer authorizations for residential SUD care across ASAM levels. This role links the clinical team, payers, and the RCM department to protect revenue and document medical necessity throughout each patient episode.

Reporting to leadership, you will drive authorization approval rates, support denials prevention, and collaborate across facilities in CO, OH, IN, KY, and AR with a remote-friendly,

Qualifications

• Active, unrestricted clinical license in good standing.
• Minimum 2 years in utilization review or care coordination in behavioral health.
• Demonstrated knowledge of ASAM criteria and medical necessity submissions.
• Experience completing concurrent reviews with payers for residential SUD.

Responsibilities

• Complete pre-certification, initial, concurrent, and discharge reviews for residential SUD levels of care.
• Submit clinical information to payers within required timeframes using ASAM criteria and payer guidelines.
• Track all authorization requests, approvals, days approved, and denials in UR system.
• Escalate authorization issues and coordinate peer-to-peer reviews with clinical leadership.
• Review clinical documentation for alignment with billed level of care and address mismatches.

Skills

Clinical license knowledge

Utilization review

ASAM criteria understanding

Medical necessity documentation

Communication skills

Electronic health records

Education

Active clinical license (RN/LPN/LCSW/LPC/LMFT/LCDC/LADC)

Tools

Payer portals

Job description

Sheridan Grove Recovery is seeking a motivated Utilization Review Coordinator to secure and maintain payer authorizations for residential SUD care across ASAM levels. This role links the clinical team, payers, and the RCM department to protect revenue and document medical necessity throughout each patient episode.

Reporting to leadership, you will drive authorization approval rates, support denials prevention, and collaborate across facilities in CO, OH, IN, KY, and AR with a remote-friendly,