Utilization Review Coordinator

Northpoint-Recovery-Holdings,-LL; Meridian (ID); Remote; USD 28,000 - 34,000; Full time

Job summary

Northpoint Recovery Holdings, LLC is seeking a Remote Utilization Review (UR) Coordinator to support the UR function across markets. You will coordinate authorization tracking, payer correspondence, and clinical documentation to ensure timely patient service authorizations.

This role collaborates with UR Specialists, Clinical Operations, and Revenue Cycle Management to streamline processes while maintaining HIPAA compliance.

Responsibilities

• Monitor authorization work queues and tracking tools to manage pending, approved, denied, and expiring authorizations.
• Coordinate collection and submission of clinical documentation for payers (progress notes, treatment plans, assessments, discharge summaries).
• Upload, fax, electronically transmit, or submit documentation through payer portals and verify receipts.

Job description

Reports To: Revenue Cycle Management Leadership

Location: Remote

FLSA Status: Temporary to Direct Hire

Schedule: Monday-Friday 8am-5pm

Compensation: $20-25/hour

Northpoint Recovery Holdings, LLC began 2009 as Ashwood Outpatient and officially launched the Northpoint platform in 2015. Now celebrating 10 years of growth in 2025, Northpoint is a leading behavioral healthcare provider offering evidence-based treatment for adults with substance use and co-occurring disorders through the Northpoint Recovery brand, and mental health treatment for adolescents through the Imagine by Northpoint. Operating under an in-network, commercial insurance model, Northpoint has grown exclusively through de novo expansion-from two facilities to twenty across the Western U.S.-with more planned in both existing and new markets. We’re guided by core values of humility, heart, inspiration, and conviction. Our mission is simple: saving lives and restoring relationships by helping people get their lives back, and treating every individual with empathy and respect.

POSITION SUMMARY:

As a key member of the Northpoint team, he Utilization Review Coordinator supports Northpoint's Utilization Review (UR) function by coordinating the administrative and operational components of the authorization process and providing direct support to Utilization Review Specialists across assigned markets. This position serves as a centralized resource for authorization tracking, payer correspondence, clinical documentation coordination, payer portal activity, record submission, routine payer follow-up, and other activities necessary to support timely authorization of patient services. Working closely with Utilization Review Specialists, Clinical Operations, Assessment Dept, Revenue Cycle Management, and other internal stakeholders, the UR Coordinator helps ensure authorization-related information is complete, submitted timely, accurately documented, and effectively communicated. The position is designed to increase the capacity and effectiveness of the Utilization Review team by reducing administrative burden on UR Specialists, allowing them to focus more heavily on concurrent review, medical necessity, complex payer communication, authorization risk, and denial prevention. The UR Coordinator will also develop foundational knowledge of utilization management, behavioral health levels of care, payer requirements, and authorization processes, creating an opportunity for professional development within the Utilization Review function.

ESSENTIAL RESPONSIBILITIES AND DUTIES INCLUDE:

• Monitor authorization work queues, fax queues, and tracking tools to assist with the management of pending, approved, denied, and expiring authorizations.
• Track authorization dates, approved units/days, expiration dates, payer reference numbers, and other required authorization information.
• Proactively identify upcoming authorization expirations and communicate deadlines or outstanding requirements to the appropriate UR Specialist.
• Coordinate the timely collection and submission of clinical documentation required by payers, including progress notes, treatment plans, assessments, discharge summaries, and other requested records.
• Upload, fax, electronically transmit, or submit clinical documentation through designated payer portals and verify successful receipts.
• Perform routine payer follow-up regarding authorization status, receipt of documentation, outstanding information requests, and other administrative requirements.
• Support UR Specialists in preparing and organizing documentation required for initial and concurrent authorization reviews.
• Assist with payer portal activity, authorization status verification, and other non-clinical payer communication.
• Maintain accurate and timely authorization information, payer correspondence, and supporting documentation within KIPU and other designated systems.
• Coordinate administrative requirements associated with peer-to-peer reviews, payer escalations, and authorization appeals, including scheduling and documentation preparation.
• Support discharge-related UR documentation and ensure appropriate discharge summary of authorization records.
• Maintain organized payer reference materials, authorization requirements, workflows, and departmental resources.
• Assist with the development and maintenance of UR standard operating procedures, payer guides, workflows, and training materials.
• Provide cross-market support based on authorization volume, staffing needs, and departmental priorities.
• Partner with Clinical Operations, Admissions, Billing, and other RCM functions to resolve routine authorization-related issues and ensure continuity of information throughout the patient revenue cycle.
• Participate in departmental meetings, training, payer education, and process-improvement initiatives.
• Maintain confidentiality of patient information and comply with HIPAA, organizational policies, payer requirements, and applicable regulatory standards.
• Perform other duties as assigned to support the Utilization Review and Revenue Cycle Management functions