Behavioral Health Utilization/Authorization Specialist

Behavioral Health Utilization/Authorization Specialist Sandy, UT Job Details Full-time $20 - $25 an hour 22 hours ago Benefits Disability insurance Health insurance Dental insurance Paid time off Employee assistance program Vision insurance Life insurance Qualifications Appeals Google Workspace Insurance prior authorization Utilization review EHR systems Patient advocacy Mid-level Microsoft Office Outpatient High school diploma or

GED ICD-10 EMR/EHR

Analysis skills Utilization management Clinical documentation Data entry Medical insurance appeals management Organizational skills EMR systems Working with individuals with mental health conditions Client advocacy in social work Productivity software Associate's degree Communication skills Under 1 year Behavioral health Full Job Description About Us Threshold Billing Solutions provides specialized claims processing and utilization management services for behavioral health treatment facilities. We work closely with providers, insurers, and managed care organizations to ensure clients receive the highest level of care supported by clinical necessity and payer requirements. Position Summary The Utilization/Authorization Specialist plays a key role in advocating for clients by obtaining treatment authorizations and facilitating communication between providers and insurance payers. This position is responsible for reviewing clinical documentation, submitting authorization requests, and ensuring accurate, timely tracking of coverage. The ideal candidate will be detail-oriented, organized, and capable of communicating clearly with both internal teams and external insurance representatives. Experience in Utilization Review Not Required While prior utilization review experience is always valued, many of our most successful team members have come from a variety of backgrounds within the behavioral health treatment field. Candidates who have worked in residential treatment centers, outpatient programs, or other clinical/administrative behavioral health settings often transition very well into this role. Their firsthand understanding of the treatment process, client needs, and clinical workflows provides an excellent foundation for learning utilization review. We provide comprehensive training and ongoing support , so if you bring a strong work ethic, attention to detail, and a passion for supporting access to care, you can thrive with us—even without previous UR experience. Key Responsibilities Maintain proactive and effective communication with insurance payers and managed care organizations. Review and interpret clinical documentation, case notes, and assessments to determine and advocate for the appropriate level of care. Prepare and submit initial and concurrent authorization requests, as well as appeals when necessary. Enter and update authorization details in internal data systems accurately and promptly. Track ongoing authorization needs across all levels of care (RTC, PHP, IOP, OP). Communicate with facility staff and internal departments regarding client coverage and clinical needs. Serve as a client advocate, ensuring access to appropriate care through effective payer communication. Ensure timely documentation of all authorizations, decisions, and payer communications. Perform other related duties as assigned. Qualifications Experience in behavioral health or utilization review preferred (but not required). Knowledge of

CPT/ICD-10

coding, ASAM/LOCUS criteria, and EMR systems is a plus. Strong verbal and written communication skills. Excellent organization and attention to detail; able to manage multiple tasks and priorities. Critical thinking and analytical skills with the ability to interpret and present clinical information. Ability to work independently and as part of a collaborative team. Proficiency in Microsoft Office and Google Workspace. Comfortable working in a fast-paced environment with deadlines and competing priorities. Education & Experience High school diploma or equivalent required. Associate's degree or higher preferred. At least 1 year of experience in behavioral health or utilization review preferred (not required). Prior experience in the substance use and/or mental health treatment field is highly valued. Benefits Health, dental, and vision insurance Paid time off (PTO) Life insurance Short- and long-term disability coverage Supportive, team-oriented work environment Work Environment This is a full-time, on-site position located at our Sandy, Utah office.

To Apply:

Please submit your resume and a brief cover letter detailing your interest in the role and relevant experience.

Job Type:

Full-time Pay:

$20.00 - $25.00 per hour

Benefits:

Dental insurance Disability insurance Employee assistance program Health insurance Life insurance Paid time off Vision insurance People with a criminal record are encouraged to apply Ability to

Commute:

Sandy, UT 84070 (Required) Ability to

Relocate:

Sandy, UT 84070: Relocate before starting work (Required)

Work Location:

In person