Utilization Review Specialist

Job Description

Job Description

Exciting Opportunity with Banyan Treatment Centers!

We are seeking a Utilization Review Specialist to join our corporate team in Pompano Beach, FL. The position is responsible for contacting external case managers and managed care organizations for pre-authorization and concurrent reviews for the duration of a patient’s treatment stay. They also establish and maintain contracts with managed care companies and requests rate increases when deemed appropriate.

Position Details :

• Reports To : Director of Utilization Review
• Schedule : Full-Time, Weekdays (Weekend availability as needed).
• Location : Pompano Beach, FL (On-site).

Key Responsibilities :

Manage a caseload of 50–75 patients and authorize 15–25 cases daily, ensuring timely utilization reviews and appropriate level of care.

Verify insurance benefits , coordinate authorizations, and communicate effectively with managed care providers.

Conduct admission and continuing-stay reviews to assess medical necessity and ensure compliance with treatment standards.

Collaborate with clinical and billing departments to support discharge planning, documentation, and timely reimbursement.

Identify and address over / underutilization trends and assist in resolving outstanding case issues with insurers.

Requirements :

Why Join Banyan Treatment Centers?

This is more than a job, it’s a chance to be a vital part of what recovery looks like after treatment. As a Utilization Review Specialist , you’ll help ensure that each client leaves treatment with a clear plan, strong connections, and the resources they need to continue their recovery journey with confidence.

Apply Now!

If you're passionate about building bridges to lasting recovery and ensuring every patient has a plan beyond our doors, apply today and help us continue making a difference at Banyan Treatment Centers.

We are an Equal Opportunity Employer and welcome applicants of all backgrounds. We encourage veterans, active-duty military, and first responders to apply in support of our First Responders Program.