Description
The Utilization Review Specialist will work in an office-based setting in Trenton, Mercer County, New Jersey, handling prior authorizations, concurrent and continued-stay reviews, appeal reviews, insurance-coverage verification, presumptive eligibility, and coordination with payers, program leadership, and accounts receivable. The role requires a bachelor's degree in a relevant behavioral health, human services, nursing, or healthcare field or an LPN/RN, at least two years of relevant behavioral health or healthcare experience, knowledge of healthcare claims and prior authorizations, proficiency with Microsoft Office, electronic health records, and databases such as NJSAMs and Navinet, strong clinical documentation and communication skills, and a valid driver's license. The position pays $55,000 and includes medical, dental, vision, 403(b), paid time off, and supplemental income benefits.
