Utilization Review Specialist

Job overview

The Utilization Review Specialist role is open to candidates near Chadds Ford, PA, and Wyomissing, PA, with hybrid or remote options based on business needs; the schedule is Monday–Friday. Compensation is not specified. The specialist supports Diversified Treatment Alternative Centers’ behavioral health programs. The role manages authorization and eligibility processes to help ensure services are medically necessary, appropriately authorized, and compliant with payer and regulatory requirements. It works with clinical, admissions, and revenue cycle teams to support timely reimbursement, quality care, and denial prevention.

What you'll do

• Conduct initial, concurrent, and continued-stay utilization reviews
• submit, track, and manage authorizations and reauthorizations
• communicate authorization updates
• maintain documentation in EHR and billing systems
• verify eligibility and report coverage changes
• review clinical documentation for medical necessity and compliance
• work with clinicians to address documentation gaps
• support denial prevention, appeals, audits, quality improvement, and compliance reviews
• monitor payer and regulatory updates.

What we're looking for

Skills & competencies

utilization review specialist

behavioral health

utilization review

authorizations

eligibility verification

medical necessity

revenue cycle

chadds ford pa

wyomissing pa

hybrid or remote

monday–friday

ehr documentation

Work arrangement

• Weekend coverage required

Benefits & perks

• 401(k)
• health, dental, and vision insurance
• health savings account
• paid time off
• life and disability insurance
• employee assistance program
• referral program.

Why this role

Hybrid or remote work options are available based on organizational needs, with candidates near Chadds Ford or Wyomissing considered.

About the employer

Diversified Treatment Alternative Centers is hiring for this role. Industry: Outpatient Mental Health and Substance Abuse Centers. Sector: 62.