Utilization Review (UR) Specialist
Solution Based Therapeutics · Boca Raton, Florida, United States
FULL TIMEpermanent
Job Description
Utilization Review (UR) Specialist
Find out more about the daily tasks, overall responsibilities, and required experience for this opportunity by scrolling down now.
Location: Boca Raton, FLJob Type: Full-time, In-PersonPay: $60,000 – $70,000 per year, based on experience
We are seeking a full-time Utilization Review (UR) Specialist to join our team in Boca Raton, FL. We provide boutique medical billing services specifically for substance abuse and mental health treatment facilities.
This role is ideal for someone with utilization review experience, clinical knowledge, strong communication skills, and the ability to thrive in a structured, fast-paced, deadline-driven environment. The right candidate will be organized, detail-oriented, coachable, and comfortable advocating on behalf of treatment facilities with insurance carriers.
The UR Specialist will be responsible for timely payer outreach, clean documentation, consistent follow-up, and close coordination with clinical teams. This position requires reliability, attention to detail, strong documentation habits, and the ability to follow established workflows.
Responsibilities:Advocate on behalf of assigned facilities with insurance carriersCommunicate effectively with clinical teams to understand patient treatment needsWork collaboratively with insurance providers, care managers, clinicians, admissions teams, and facility staffTrack authorization start and end dates to help prevent lapses in coverageDocument payer interactions, reference numbers, authorization outcomes, and determinations clearly and accuratelyProvide detailed feedback and clinical quality management support to assigned facilitiesCoordinate with clinical staff and admissions teams to ensure payer needs are met quicklyFollow established utilization review workflows and participate in ongoing training and coachingManage a caseload of approximately 30–50 patientsMaintain professional verbal and written communication internally and externallyStay focused, organized, and detail-oriented throughout the daySupport continuous improvement through accuracy, consistency, and reliable executionMultitask effectively while working as part of a teamHandle reviews after standard business hours as needed
Qualifications:Minimum of 2 years of utilization review experience requiredMinimum of 4 years of experience in substance abuse or mental health treatment required3+ years of clinical experience preferredStrong working knowledge of ASAM and LOCUS criteriaExperience using EMR software requiredKipu experience requiredHigh School Diploma or equivalent requiredBachelor’s degree preferredProficiency with Google Docs, Google Drive, and related Google applicationsExcellent customer service xzbcwsv skillsStrong verbal and written communication skillsAbility to understand and contribute within a multidisciplinary team environmentStrong organization, time management, and attention to detail
Ideal Candidate Traits:Highly coachable and willing to learn structured systemsDeadline-aware and able to track authorization timelines carefullyDetail-oriented with strong documentation habitsReliable, accountable, and consistent in daily executionComfortable with repetitive follow-up workAble to work in a structured, high-accountability environmentProfessional, motivated, and eager to grow with the company
Benefits:Health insuranceDental insuranceVision insuranceLife insurancePaid time offEmployee assistance program
Work Location: In person
Find out more about the daily tasks, overall responsibilities, and required experience for this opportunity by scrolling down now.
Location: Boca Raton, FLJob Type: Full-time, In-PersonPay: $60,000 – $70,000 per year, based on experience
We are seeking a full-time Utilization Review (UR) Specialist to join our team in Boca Raton, FL. We provide boutique medical billing services specifically for substance abuse and mental health treatment facilities.
This role is ideal for someone with utilization review experience, clinical knowledge, strong communication skills, and the ability to thrive in a structured, fast-paced, deadline-driven environment. The right candidate will be organized, detail-oriented, coachable, and comfortable advocating on behalf of treatment facilities with insurance carriers.
The UR Specialist will be responsible for timely payer outreach, clean documentation, consistent follow-up, and close coordination with clinical teams. This position requires reliability, attention to detail, strong documentation habits, and the ability to follow established workflows.
Responsibilities:Advocate on behalf of assigned facilities with insurance carriersCommunicate effectively with clinical teams to understand patient treatment needsWork collaboratively with insurance providers, care managers, clinicians, admissions teams, and facility staffTrack authorization start and end dates to help prevent lapses in coverageDocument payer interactions, reference numbers, authorization outcomes, and determinations clearly and accuratelyProvide detailed feedback and clinical quality management support to assigned facilitiesCoordinate with clinical staff and admissions teams to ensure payer needs are met quicklyFollow established utilization review workflows and participate in ongoing training and coachingManage a caseload of approximately 30–50 patientsMaintain professional verbal and written communication internally and externallyStay focused, organized, and detail-oriented throughout the daySupport continuous improvement through accuracy, consistency, and reliable executionMultitask effectively while working as part of a teamHandle reviews after standard business hours as needed
Qualifications:Minimum of 2 years of utilization review experience requiredMinimum of 4 years of experience in substance abuse or mental health treatment required3+ years of clinical experience preferredStrong working knowledge of ASAM and LOCUS criteriaExperience using EMR software requiredKipu experience requiredHigh School Diploma or equivalent requiredBachelor’s degree preferredProficiency with Google Docs, Google Drive, and related Google applicationsExcellent customer service xzbcwsv skillsStrong verbal and written communication skillsAbility to understand and contribute within a multidisciplinary team environmentStrong organization, time management, and attention to detail
Ideal Candidate Traits:Highly coachable and willing to learn structured systemsDeadline-aware and able to track authorization timelines carefullyDetail-oriented with strong documentation habitsReliable, accountable, and consistent in daily executionComfortable with repetitive follow-up workAble to work in a structured, high-accountability environmentProfessional, motivated, and eager to grow with the company
Benefits:Health insuranceDental insuranceVision insuranceLife insurancePaid time offEmployee assistance program
Work Location: In person
Details
| Company | Solution Based Therapeutics |
| Location | Boca Raton, Florida, United States |
| Type | FULL TIME |
| Niche | healthcare |
| Experience | permanent |