Utilization Review Lead

Reveloop RCM is a fast-growing revenue cycle management company specializing in behavioral health and medical billing services. We help providers streamline authorizations, reviews, and appeals so they can focus on patient care.

We are seeking a Utilization Review Lead to manage our UR team, ensure timely and accurate submissions, and oversee prior authorizations, continued stay reviews, and appeals. This is a leadership role requiring deep knowledge of utilization management and strong communication skills.

Lead and supervise the Utilization Review team Monitor productivity, quality, and compliance with payer guidelines Handle escalated cases, denials, and appeals Provide training, coaching, and support to UR staff Ensure timely submission of authorizations and clinical documentation Stay current on payer requirements and clinical review criteria (InterQual, MCG) Collaborate with providers and internal departments for case resolution Identify process improvements for efficiency and accuracy