What are the responsibilities and job description for the Utilization Review Coordinator position at Clear Behavioral Health?
About Us:
Your Behavioral Health is dedicated to providing exceptional, evidence-based mental health and addiction treatment through Clear Behavioral Health and Neuro Wellness Spa. Our UR team plays a vital role in ensuring clients receive timely and medically necessary care.
Position Overview:
We are seeking a detail-oriented, proactive Utilization Review (UR) Coordinator to support insurance authorization processes across all levels of care — including Detox, Residential, PHP, IOP — as well as Transcranial Magnetic Stimulation (TMS) services. The UR Coordinator will collaborate closely with clinical teams and payors to advocate for clients, secure appropriate insurance authorizations, and support a smooth treatment experience.
Key Responsibilities:
Insurance Authorizations:
- Obtain initial and concurrent authorizations for Detox, Residential, PHP, and IOP programs
- Obtain TMS service authorizations for Neuro Wellness Spa
- Conduct clinical reviews and advocate with commercial health plans to support medically necessary care
- Track authorization timelines and follow up promptly on outstanding requests
Documentation & Systems:
- Maintain accurate, real-time records of authorization activity in Kipu and related systems
- Gather and review clinical documentation to support authorization requests
- Document all communications with payors clearly and thoroughly
Collaboration & Communication:
- Communicate regularly with insurance representatives, clinical teams, and leadership about authorization status and updates
- Work collaboratively with the UR team to improve processes and enhance coordination of care
Denials & Appeals Support:
- Assist with denial management, support appeal efforts with case summaries and clinical data
- Help identify trends in authorization delays or denials and provide input to leadership
Other Duties:
- Perform other responsibilities as assigned to support team goals and company needs
Qualifications:
- 1–2 years of utilization review experience, preferably in behavioral health or mental health settings
- Experience obtaining Detox, Residential, PHP, and IOP authorizations with commercial payors
- Familiarity with TMS treatment and authorization processes
- Experience with commercial health plans and payor authorization protocols
- Proficiency with EMR systems (Kipu preferred), Microsoft Word, and Excel
- Strong written and verbal communication skills
- Ability to multitask, prioritize, and work efficiently in a fast-paced environment
- Professional, collaborative, and passionate about patient advocacy
Why Join Us?
Your Behavioral Health offers a supportive, collaborative work environment where your contributions truly matter. Join our team and help us advocate for access to high-quality mental health care!
Apply Today!
Job Type: Full-time
Pay: $22.00 - $26.00 per hour
Expected hours: 40 per week
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
Application Question(s):
- This position is fully in person, does that work for you?
- Why would you be a good fit for this position?
Education:
- Bachelor's (Preferred)
Experience:
- Administrative: 1 year (Preferred)
Ability to Commute:
- Torrance, CA 90504 (Required)
Ability to Relocate:
- Torrance, CA 90504: Relocate before starting work (Required)
Work Location: In person
Salary : $22 - $26