UR Coordinator

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

Schedule: Full Time
Location: Blue Ash, OH
Compensation: $18 - $22 hr

Position Summary

Leora Behavioral Health is seeking a detail-oriented and organized Utilization Review (UR) Coordinator to support the coordination, documentation, and timely submission of utilization review activities for behavioral health services. The UR Coordinator will work closely with clinical teams, insurance companies, utilization management representatives, and other internal departments to help ensure services are appropriately authorized, documented, and aligned with payer requirements.

The ideal candidate is highly organized, comfortable working with confidential clinical information, able to manage multiple deadlines, and experienced with insurance authorizations or behavioral health administrative processes.

Key Responsibilities

• Coordinate initial, concurrent, retrospective, and continued-stay utilization review activities as applicable.
• Monitor authorization periods, review dates, and payer deadlines to help prevent gaps in authorization.
• Obtain and maintain insurance eligibility, benefits, authorization, and clinical review information.
• Prepare and submit required documentation to insurance companies and utilization management organizations.
• Coordinate clinical information between treating providers and payers while maintaining appropriate confidentiality.
• Track authorization requests, determinations, extensions, denials, and appeals in the appropriate systems.
• Maintain accurate and timely UR records, logs, and documentation.
• Communicate with insurance representatives regarding authorization requirements, documentation needs, and review status.
• Notify appropriate clinical and administrative staff of authorization decisions and upcoming deadlines.
• Escalate potential authorization barriers, denials, or urgent payer issues to the appropriate clinical or leadership team member.
• Assist with preparing documentation for peer-to-peer reviews and appeals when requested.
• Collaborate with admissions, clinical, billing, and revenue-cycle teams to support continuity of care and accurate reimbursement.
• Ensure documentation and processes are consistent with organizational policies, payer requirements, and applicable regulatory standards.
• Protect patient privacy and maintain compliance with HIPAA and organizational confidentiality policies.
• Participate in quality-improvement initiatives related to utilization management and authorization processes.
• Perform other duties as assigned.

Qualifications

Required

• High school diploma or equivalent; associate or bachelor's degree in healthcare administration, behavioral health, nursing, social services, or a related field preferred.
• Previous experience in healthcare, behavioral health, utilization review, insurance authorizations, medical necessity review support, or a related administrative role.
• Strong organizational and time-management skills.
• Excellent written and verbal communication skills.
• Strong attention to detail and ability to meet time-sensitive deadlines.
• Ability to work effectively with clinicians, insurance companies, patients/families, and administrative staff.
• Ability to handle confidential patient and insurance information appropriately.
• Proficiency with electronic health records (EHRs), Microsoft Office, and/or other healthcare information systems.

Why Join Us?

• Medical, Dental, Vision, and Life Insurance
• 401(k) with Company Match
• Paid Time Off (PTO) and Paid Holidays
• Tuition Reimbursement (up to $15,000) and Student Loan Forgiveness Programs
• Career Growth and Professional Development Opportunities