Champions for behavioral health and substance use care
Utilization Review Coordinator
Location
California + 1 moreAll locations: California | Washington
Posted
106 days ago
Salary
$70K - $80K / year
Seniority
Mid Level
Job Description
Utilization Review Coordinator
COPA - The Colorado Providers Association
• Reporting directly to the Director of Revenue Cycle Management. • Handling pre-certifications, authorizations, retro-authorizations, appeals, medical records requests, and chart auditing duties. • Partner closely with clinical and revenue cycle teams to remove administrative barriers. • Conduct live reviews with payors and level of care chart reviews. • Clinically negotiate authorization outcomes with the payor. • Provide guidance and training to clinicians on completing P2P reviews. • Timely completion of the Denial Notification process.
Job Requirements
- Bachelor's degree in Social Work, Nursing, or any related field.
- Must be based in PST, with an understanding of the west coast Payer landscape, specifically CA or WA.
- 2-3+ years of UR experience in behavioral health, ideally across PHP or IOP levels of care.
- Knowledge of medical necessity criteria, payer authorization processes, documentation standards, and regulatory requirements.
- Proficient in MS Office applications and ability to learn department and job-specific software systems.
- Strong organizational, communication, analytical, and problem-solving skills with exceptional attention to detail.
Benefits
- Medical, dental, vision, HealthJoy unlimited therapy, UHC wellness program, HSA/FSA options, and pet insurance.
- Responsible PTO, in lieu of a traditional accrual-based policy.
- 401(k) with company match.
- All licensing fees covered.
- Annual stipend for tuition reimbursement, ongoing education, or CEUs.
- Pre-licensed clinicians receive structured clinical supervision toward licensure.
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