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Wellbrook Recovery

Utilization Review Specialist-Remote

Career Insights for Clinical Auditor / Utilization Reviewer

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What they do

A Clinical Auditor or Utilization Reviewer reviews the efficiency of healthcare delivery. Individuals tend to have had experience as a registered nurse or other healthcare delivery roles before transferring into this quality review role.

$93,054 / year median in the U.S.

-10% projected decline

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Job Description

Utilization Review Specialist - Behavioral Health Facility We are seeking a confident, detail-oriented Utilization Review Specialist to join our behavioral health team. This role involves reviewing clinical documentation, ensuring medical necessity, managing insurance authorizations, and collaborating with providers to support appropriate and timely care for our clients.
Responsibilities:
Conduct utilization reviews and obtain prior authorizations from insurance companies Monitor continued stay and discharge criteria for clients Communicate effectively with clinical and administrative teams Maintain accurate and up-to-date documentation Ensure all documentation meets insurance and regulatory compliance standards and is completed accurately and on time.
Qualifications:
Background or experience in social work, counseling, or behavioral health is preferred Experience in utilization review or case management for behavioral health is preferred Strong communication and organization skills Ability to work efficiently in a fast-paced environment Confident, proactive, and dedicated work ethic
Benefits:
Competitive salary Opportunities for professional development and career advancement Supportive and collaborative work environment Fulfilling work helping individuals with mental health or substance abuse issues
Benefits:
401(k) Dental insurance Flexible schedule Health insurance Life insurance Paid time off Vision insurance