Utilization Review (UR) Coordinator

Schedule: Full Time
Location: Blue Ash, OH
Compensation: $18 - $22 hr

Position Summary

Leora Behavioral Health is seeking a detail-oriented and organized Utilization Review (UR) Coordinator to support the coordination, documentation, and timely submission of utilization review activities for behavioral health services. The UR Coordinator will work closely with clinical teams, insurance companies, utilization management representatives, and other internal departments to help ensure services are appropriately authorized, documented, and aligned with payer requirements.

The ideal candidate is highly organized, comfortable working with confidential clinical information, able to manage multiple deadlines, and experienced with insurance authorizations or behavioral health administrative processes.

Key Responsibilities

• Coordinate initial, concurrent, retrospective, and continued-stay utilization review activities as applicable.
• Monitor authorization periods, review dates, and payer deadlines to help prevent gaps in authorization.
• Obtain and maintain insurance eligibility, benefits, authorization, and clinical review information.
• Prepare and submit required documentation to insurance companies and utilization management organizations.
• Coordinate clinical information between treating providers and payers while maintaining appropriate confidentiality.
• Track authorization requests, determinations, extensions, denials, and appeals in the appropriate systems.
• Maintain accurate and timely UR records, logs, and documentation.
• Communicate with insurance representatives regarding authorization requirements, documentation needs, and review status.
• Notify appropriate clinical and administrative staff of authorization decisions and upcoming deadlines.
• Escalate potential authorization barriers, denials, or urgent payer issues to the appropriate clinical or leadership team member.
• Assist with preparing documentation for peer-to-peer reviews and appeals when requested.
• Collaborate with admissions, clinical, billing, and revenue-cycle teams to support continuity of care and accurate reimbursement.
• Ensure documentation and processes are consistent with organizational policies, payer requirements, and applicable regulatory standards.
• Protect patient privacy and maintain compliance with HIPAA and organizational confidentiality policies.
• Participate in quality-improvement initiatives related to utilization management and authorization processes.
• Perform other duties as assigned.

Qualifications

Required

• High school diploma or equivalent; associate or bachelor's degree in healthcare administration, behavioral health, nursing, social services, or a related field preferred.
• Previous experience in healthcare, behavioral health, utilization review, insurance authorizations, medical necessity review support, or a related administrative role.
• Strong organizational and time-management skills.
• Excellent written and verbal communication skills.
• Strong attention to detail and ability to meet time-sensitive deadlines.
• Ability to work effectively with clinicians, insurance companies, patients/families, and administrative staff.
• Ability to handle confidential patient and insurance information appropriately.
• Proficiency with electronic health records (EHRs), Microsoft Office, and/or other healthcare information systems.