What are the responsibilities and job description for the Utilization Review Specialist position at Clean and Clear Advantage, LLC?
Now offering company-paid dental, vision, and life insurance
We are actively seeking a detail-oriented and compassionate professional to work as a Utilization Review (UR) Specialist in our residential substance use treatment program. This position is ideal for individuals with experience in healthcare administration, utilization review, case management, or insurance coordination within behavioral health or substance use treatment settings.
Description:
As a Utilization Review Specialist, you will play a critical role in supporting client care by ensuring appropriate authorization, continued stay approvals, and compliance with payer requirements. You will work closely with the clinical and administrative teams to advocate for clients and support continuity of care while maintaining accurate documentation and timely communication with insurance providers.
We currently observe 6 National holidays as paid days off for our full-time staff:
- New Year’s Day
- Memorial Day
- Independence Day
- Labor Day
- Thanksgiving Day
- Christmas Day
Full-time staff receive 56 hours of paid time off after 90 days of continuous employment and begin earning vacation time.
Key Responsibilities:
- Submit and manage initial and continued stay authorizations with insurance providers
- Review clinical documentation to ensure medical necessity and payer compliance
- Communicate with insurance companies regarding treatment approvals, denials, and appeals
- Collaborate with therapists, case managers, and nursing staff to support treatment planning
- Maintain accurate, timely, and confidential documentation
- Track authorization timelines and proactively prevent lapses in coverage
Qualifications:
- Associate’s or Bachelor’s degree in healthcare administration, social services, or a related field (preferred)
- Prior experience in utilization review, insurance authorization, or behavioral health billing strongly preferred
- Knowledge of substance use or mental health treatment settings is a plus
- Strong organizational, communication, and documentation skills
- Ability to work independently while collaborating with a multidisciplinary team
Benefits:
- Medical Insurance Coverage
- Company-paid Dental, Vision, & Life Insurance
- Paid Time Off (Sick/Personal Days)
- Vacation Time
- Opportunities to advance career
Organization Overview:
Here at Clean & Clear Advantage, LLC, we are committed to providing high-quality and professional services in our residential substance use treatment facility located in Parkersburg, West Virginia. Our region has been heavily impacted by the opioid and substance abuse epidemic, and our team of compassionate professionals works tirelessly to support individuals on their recovery journey.
Our client-centered approach focuses on the whole person, addressing physical, mental, and spiritual health. Our multidisciplinary team provides evidence-based treatment approaches including medication-assisted treatment, cognitive behavioral therapy, acceptance and commitment therapy, and motivational interviewing.
Our mission to help eliminate the substance abuse crisis begins with dedicated professionals like you. Join our team and make a meaningful impact on under-resourced and under-served populations.
If you are a dedicated professional with a passion for ensuring quality healthcare services, we would love to hear from you. Join our team as a Utilization Review Specialist and make a difference in the lives of our patients.
Job Type: Full-time
Pay: $18.00 - $22.00 per hour
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Experience:
- Utilization review: 1 year (Required)
Work Location: In person
Salary : $18 - $22