Utilization Review Coordinator – Healthcare Liaison

San Antonio Behavioral Healthcare Hospital; San Antonio (TX); On-site; USD 55,000 - 75,000; Full time

Benefits offered by this job

Health Insurance

Vision Insurance

Dental Insurance

401K Retirement Plan

Healthcare Spending Account

Dependent Care Spending Account

PTO Plan with Holiday Premium Pay

Life Insurance

Short and Long-Term Disability

Job summary

San Antonio Behavioral Healthcare Hospital is seeking a Utilization Review Coordinator to bridge clinicians, patients, and insurers, evaluating medical records for medical necessity and securing insurance authorizations.

You will participate in interdisciplinary treatment planning, monitor length of stay, and draft urgent appeal packets within tight timelines, ensuring compliance with HIPAA and regulatory standards.

Qualifications

• High school diploma or GED required; Bachelor’s degree preferred.
• Experience in behavioral healthcare preferred.
• Must have CPR certification and de-escalation training.
• Strong verbal and written communication to translate insurance rules.

Responsibilities

• Submit prior authorization and certification documentation to insurers.
• Evaluate medical records for medical necessity.
• Ensure HIPAA compliance and auditing standards.
• Serve as liaison between clinical staff, billing, and payers.
• Attend interdisciplinary treatment team meetings to align care with approved days.
• Monitor length of stay against insurance timelines.
• Advise on required documentation to justify continued care to insurers.
• Review denial letters to identify contractual or clinical reasons.
• Schedule and prepare psychiatrists for peer-to-peer reviews.
• Draft urgent appeal packets within 24–72 hours when needed.
• Perform other duties as required by the organization.

Skills

Verbal skills

Written skills

Medical records review

Data extraction

Negotiation

Organizational skills

Problem solving

Microsoft Office Suite

Education

High school diploma/GED

Bachelor's degree preferred

Tools

Microsoft Office Suite

Job description

San Antonio Behavioral Healthcare Hospital is seeking a Utilization Review Coordinator to bridge clinicians, patients, and insurers, evaluating medical records for medical necessity and securing insurance authorizations.

You will participate in interdisciplinary treatment planning, monitor length of stay, and draft urgent appeal packets within tight timelines, ensuring compliance with HIPAA and regulatory standards.