Utilization Review

3 weeks ago


Skokie, United States Spectrum Billing Solutions Full time

Spectrum Billing Solutions is an industry-leading revenue cycle management company for healthcare organizations. We are looking to add a Utilization Review (UR) Specialist to our growing team. The UR Specialist will utilize his or her knowledge and skills to review clinical information and obtain initial and continuing authorizations for behavioral healthcare services.  The ideal candidate is passionate, motivated, detail-oriented, and interested in working in a cohesive and rewarding environment.

This is a remote or office/home hybrid position.

Responsibilities include:

  • Review patient admission and clinical information to ensure medical necessity and compliance of utilization review guidelines.
  • Obtain initial and continuing authorization for treatment services.
  • Manage authorization denials including referral for peer review.
  • Demonstrate the ability to make critical decisions about medical necessity of treatment by using good judgment.
  • Advocate on behalf of patients to ensure maximum length of stay at the appropriate level of care.
  • Interact with insurance companies in a respectful, professional manner that facilitates the utilization review process and follows policies and procedures.
  • Document and record all necessary information.
  • Monitor and track new and ongoing authorization cases.
  • Collaborate and communicate with clinical staff to ensure necessary information is obtained and timely reviews are performed.
  • Assist the treatment team in understanding payer requirements for admission, continued stay and discharge planning.
  • Participate in team meetings and case conference reviews.
  • Perform other duties as assigned.
  • Maintain confidentiality of patient information and adhere to HIPAA regulations

Minimum requirements:

  • 3-5 years of related ABA, Substance Abuse, and/or Mental Health experience.
  • Bachelor’s or master’s degree preferred.
  • Superior written and oral communication skills
  • Attention to detail to ensure necessary information is captured and properly documented.
  • Ability to work independently and within a team.
  • Ability to multi-task, prioritize and meet expected deadlines.
  • Solid understanding of insurance benefits and coverages.
  • Strong computer skills (Word, Excel, billing software).
  • Understanding of mental and behavioral health treatment services. 

At Spectrum, you receive:

  • A close-knit team of talented and skilled individuals.
  • Growth opportunities within the organization.
  • Competitive salary.
  • Healthcare benefits including 401K, medical, dental & vision.
  • Flexible PTO.

Powered by JazzHR


  • Utilization Review

    3 weeks ago


    Skokie, United States Spectrum Billing Solutions Full time

    Spectrum Billing Solutions is an industry-leading revenue cycle management company for healthcare organizations. We are looking to add a Utilization Review (UR) Specialist to our growing team. The UR Specialist will utilize his or her knowledge and skills to review clinical information and obtain initial and continuing authorizations for behavioral...

  • Utilization Review

    3 weeks ago


    Skokie, United States Spectrum Billing Solutions Full time

    Job DescriptionJob DescriptionSpectrum Billing Solutions is an industry-leading revenue cycle management company for healthcare organizations. We are looking to add a Utilization Review (UR) Specialist to our growing team. The UR Specialist will utilize his or her knowledge and skills to review clinical information and obtain initial and continuing...


  • Skokie, United States Wells Lamont LLC Full time

    Wells Lamont LLC Come join a team where People make the difference! As a part of Marmon Holdings, Inc., a highly decentralized organization, we rely heavily on people with the aptitude, attitude, and entrepreneurial spirit to drive our success, and we're committed to attracting and retaining top talent. The Customer Service Administrator performs all order...


  • Skokie, United States Marmon Holdings, Inc. Full time

    Wells Lamont LLC Come join a team where People make the difference! As a part of Marmon Holdings, Inc., a highly decentralized organization, we rely heavily on people with the aptitude, attitude, and entrepreneurial spirit to drive our success, and we're committed to attracting and retaining top talent. The Customer Service Administrator performs all order...

  • Inventory Clerk

    3 days ago


    Skokie, United States Kelly Services Full time

    Job DescriptionJob DescriptionInventory Clerk in Skokie, ILThink the best job opportunities are far away? Think again. Great opportunities are right here in your backyard. Kelly® is looking for an Inventory Clerk to work at a premier manufacturer of aerospace parts in Skokie, IL. Let us help you grow at work and discover the next step in your career, all...


  • Skokie, Illinois, United States Tenneco Full time

    DRiV Motorparts is a world leader in the international automotive aftermarket built from the combined strengths of Tenneco, Federal-Mogul and Öhlins with 31 of the best known and respected aftermarket brands, including 14 brands 100 years or older. Our colleagues throughout 25 countries around the world work as one team, driving advancements that help our...


  • Skokie, United States Tenneco Full time

    'Own Your Career' supports Tenneco's People Model, ensuring that we both "Select the Best" and "Build & Develop" internal talent. It is our commitment to develop and promote great talent within the Tenneco team. Position Summary: This position will primarily act as a buyer and analyst for raw materials. Manage subcontracting suppliers and act as a back-up...

  • Material Handler

    6 days ago


    Skokie, United States Georgia Nut CO Full time

    Job DetailsJob Location Niles, IL - Skokie, IL Position Type Full Time Job Shift Second Shift Description SUMMARY Material Handler position with Georgia Nut Company is utilizing great physical stamina and skills in organizing, sorting and categorizing products to maximize the efficiency within the department. Material Handler is responsible for building...


  • Skokie, United States Tenneco Full time

    'Own Your Career' supports Tenneco's People Model, ensuring that we both "Select the Best" and "Build & Develop" internal talent. It is our commitment to develop and promote great talent within the Tenneco team. Position Summary: This position will primarily act as a buyer and analyst for raw materials. Manage subcontracting suppliers and act as a back-up...

  • Claims Advocate

    4 days ago


    Skokie, United States Worthy Insurance Group, LLC Full time

    Job DescriptionJob DescriptionBenefits:401(k) matchingCompany partiesCompetitive salaryDental insuranceFree food & snacksHealth insuranceOpportunity for advancementPaid time offVision insuranceClaims AdvocateWorthy Insurance Group, a national Property & Casualty Insurance Brokerage located in Skokie, IL, is looking for a Claims Advocate to join the Risk...

  • Claims Advocate

    3 days ago


    Skokie, United States Worthy Insurance Group Full time

    Benefits: 401(k) matching Company parties Competitive salary Dental insurance Free food & snacks Health insurance Opportunity for advancement Paid time off Vision insurance Claims Advocate Worthy Insurance Group, a national Property & Casualty Insurance Brokerage located in Skokie, IL, is looking for a Claims Advocate to join the Risk Management Department....

  • Claims Advocate

    3 days ago


    Skokie, United States Independent Insurance Agents Full time

    Benefits: 401(k) matching Company parties Competitive salary Dental insurance Free food & snacks Health insurance Opportunity for advancement Paid time off Vision insurance Claims Advocate Worthy Insurance Group, a national Property & Casualty Insurance Brokerage located in Skokie, IL, is looking for a Claims Advocate to join the Risk Management Department....


  • Skokie, United States Illinois CPA Society Full time

    Oakton College, a caring community of educators dedicated to excellence and learning, invites applications for the Assistant Financial Controller (AFC24) A premier comprehensive community college, Oakton is 17 miles from downtown Chicago. Oakton serves the near northern suburbs of Chicago with campuses in Des Plaines and Skokie with buildings totaling over...

  • Pharmacy Technician

    4 days ago


    Skokie, United States Walgreens Full time

    Job Description Our pharmacy technician positions have undergone an exciting transformation, moving from a transaction-based environment to a much more patient-centric one. As a Walgreens Pharmacy Technician or Pharmacy Technician Apprentice, you'll be front and center – interacting with our customers and developing strong patient relationships....

  • REGISTERED NURSE

    2 weeks ago


    Skokie, IL 60077, USA, United States Alden North Shore Rehabilitation and Health Care Center Full time

    Alden North Shore Rehabilitation and Health Care Center - JOB SUMMARY Responsible to provide direct nursing care to the customer, and to supervise the day-to- day nursing activities performed by the nursing assistants. Such supervision must be in accordance with current Federal, State, and local standards, guidelines and regulations, facility policies. The...

  • STAFF NURSE

    2 weeks ago


    Skokie, IL 60076, USA, United States Alden Estates of Skokie Full time

    Alden Estates of Skokie - *PRN REGISTERED NURSE NEEDED*  JOB SUMMARY Responsible to provide direct nursing care to the customer, and to supervise the day-to- day nursing activities performed by the nursing assistants. Such supervision must be in accordance with current Federal, State, and local standards, guidelines and regulations, facility policies. The...