Utilization Review - Newark
3 weeks ago
Job description
Utilization Review & Billing Specialist
Full-Time | Hybrid (In-Office & Remote)
Impact Life | Delaware
Impact Life is seeking a detail-oriented and mission-driven Utilization Review & Billing Specialist to support our behavioral health and recovery-oriented programs across the organization. This role is essential to ensuring access to care by navigating insurance authorizations, utilization review, and billing processes with accuracy, integrity, and compassion.
At Impact Life, we believe recovery is possible, people deserve dignity, and systems should work for people, not against them. Behind every authorization and claim is a real person seeking support, stability, and healing.
Position Overview
The Utilization Review & Billing Specialist plays a critical role in supporting access to care by managing insurance authorizations, utilization review activities, and in-house billing processes. This position works closely with clinical, admissions, and administrative teams to ensure services are authorized, documented, billed, and reimbursed accurately and in compliance with payer and regulatory requirements.
Requirements
What You'll Do
Utilization Review
- Complete initial, concurrent, and continued stay reviews with insurance providers
- Submit clinical documentation that clearly supports medical necessity
- Track authorizations, approvals, extensions, denials, and appeals
- Communicate authorization status with admissions and clinical teams
- Maintain accurate, compliant utilization review records
In-House Billing
- Submit clean, accurate insurance claims in a timely manner
- Review claims for accuracy and compliance prior to submission
- Monitor claim status and follow up on unpaid, denied, or delayed claims
- Post payments and assist with account reconciliation
- Collaborate to resolve billing issues using a solutions-focused approach
Admissions Support (Preferred)
- Assist with insurance verification and benefits checks
- Support admissions workflows as needed
- Clearly communicate coverage information to support informed decision-making
Qualifications & Experience
- Minimum of 3 years of experience in utilization review and or in-house billing
- Experience with insurance authorizations and claims submission
- Behavioral health and or substance use treatment experience strongly preferred
- Admissions or intake experience is a plus
- Strong attention to detail and organizational skills
- Ability to manage multiple priorities and work independently
- Teachable mindset with openness to learning and feedback
- Commitment to confidentiality, ethics, and compassionate care
Benefits
- Health Care Plan - Medical, Dental & Vision
- Retirement Plan - 401k & ROTH 401k
- Paid Time Off
- 11 Paid Holidays Yearly
- Training & Development
- Wellness Resources
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