Utilization Review (UR) Specialist

Zenith MB is a healthcare billing and revenue cycle management company specializing in behavioral health and substance use treatment facilities nationwide. We work closely with clinical and administrative teams to ensure compliance, continuity of care, and financial sustainability.

Zenith MB is seeking an experienced Utilization Review (UR) Specialist to support substance use disorder (SUD) and mental health treatment facilities. This role is fully remote and ideal for a detail-oriented professional with strong clinical knowledge and payer communication experience. The UR Specialist will be responsible for managing authorizations, continued stay reviews, and medical necessity submissions in compliance with payer guidelines and regulatory standards. The role supports multiple levels of care, including detox, residential, PHP, IOP, and outpatient services. Position Details Full Time Fully Remote Opportunity for growth

Obtain initial and continued stay authorizations for SA and MH services Conduct clinical reviews using ASAM and LOCUS criteria (as applicable) Communicate with insurance companies to secure authorizations and extensions Submit clinical documentation Track authorization dates, units, and due dates accurately Document all payer interactions clearly and timely Collaborate with clinical teams, billing, and operations to prevent denials Assist with peer-to-peer coordination when required Maintain compliance with payer-specific and state regulations