ABA Utilization Review (UR) Specialist
- Review patient admission and clinical information to ensure medical necessity and compliance of utilization review guidelines.
- Obtain initial and continuing authorization for treatment services.
- Manage authorization denials including referral for peer review.
- Document and record all necessary information.
- Monitor and track new and ongoing authorization cases.
- Collaborate and communicate with clinical staff to ensure necessary information is obtained and timely reviews are performed.
- Assist external clients in understanding payer requirements for authorizations.
- Participate in team meetings.
- Maintain confidentiality of patient information and adhere to HIPAA regulations.
- Flexible work environment
- Competitive Salary
- A close-knit team of talented and skilled individuals.
- Growth opportunities
- Benefits – Medical, Dental, Vision
- Flexible Paid Time Off
- 401K with Company match
- Supplemental Benefits
- 3-5 years of related ABA and/or Behavioral Health experience.
- Bachelor’s or master’s degree preferred.
- Superior written and oral communication skills
- Attention to detail to ensure necessary information is captured and properly documented.
- Ability to work independently and within a team.
- Ability to multi-task, prioritize and meet expected deadlines.
- Solid understanding of insurance benefits and coverages.
- Strong computer skills (Word, Excel, billing software).
- Understanding of mental and behavioral health treatment services.
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