Utilization Review & Billing Specialist
About Us
Bridgecrest Recovery is a substance use disorder (SUD) treatment center being built in Dubuque, Iowa, to serve individuals and families across Iowa and the Tri-State region. We will open with medically monitored detox (withdrawal management) and residential treatment, with partial hospitalization (PHP) planned as we grow. We are in the final stage of Iowa state licensure and will partner first with Iowa Medicaid's managed care plans, followed by commercial payers.
Our mission is to provide compassionate, evidence-based care for people affected by substance use and co-occurring mental health conditions, and to build a team culture grounded in safety, dignity, accountability, and long-term recovery.
Why Join Bridgecrest Recovery
Build the Revenue Cycle From Day One: Set up payer workflows for a new program.
Protect Access to Care: Your work keeps patients in treatment for as long as they medically need it.
Close-Knit Team: Work directly with clinical, medical, and leadership staff.
Role Description
The Utilization Review & Billing Specialist secures and maintains authorizations for detox and residential care and supports accurate, timely billing and collections. This role conducts concurrent reviews with payers using ASAM criteria, works with clinicians to make sure documentation supports medical necessity, and manages claims, denials, and appeals. Bridgecrest will begin with Iowa Medicaid managed care plans, then add commercial payers.
Location: Dubuque, Iowa (on-site)
Reports to: Executive Director
Utilization Review
Obtain pre-authorizations and complete concurrent and continued-stay reviews with Iowa Medicaid MCOs (Wellpoint, Iowa Total Care, Molina Healthcare of Iowa) and commercial payers.
Present clinical information using ASAM criteria to support level-of-care and length-of-stay decisions.
Coordinate peer-to-peer reviews between payers and the Medical Director, and track authorization dates and outcomes.
Give clinical and nursing teams feedback on documentation needed for medical necessity.
Billing & Revenue Cycle
Prepare, submit, and track claims for detox and residential services using appropriate HCPCS/revenue codes and payer requirements.
Post payments, manage denials, and file corrected claims and appeals promptly.
Support payer enrollment and credentialing activities and keep payer requirements current.
Report on authorizations, denials, days in A/R, and collections to leadership.
Compliance
Maintain confidentiality under HIPAA and 42 CFR Part 2.
Support audits and payer reviews.
Minimum Qualifications
2+ years of experience in utilization review, medical billing, or revenue cycle in healthcare, preferably behavioral health or SUD treatment.
Working knowledge of ASAM criteria and higher levels of care (e.g., 3.7 and 3.5), or demonstrated ability to learn quickly.
Experience with Medicaid managed care and/or commercial payer authorizations and claims.
Strong attention to detail, organization, and written communication.
Preferred Qualifications
Clinical background or credential (RN, LPN, LMSW, LISW, LMHC, CADC, or IADC), especially for the utilization review function.
Experience with Iowa Medicaid MCOs and Iowa Medicaid provider enrollment.
Billing or coding certification (e.g., CPC, CPB, or CRCR).
Experience setting up billing and UR workflows for a new program.
Experience with behavioral health EHR and clearinghouse systems.
Schedule
Full-time, primarily weekday schedule, with occasional weekend authorization coverage as needed.
Compensation & Benefits
Competitive pay, commensurate with experience.
Comprehensive benefits package.
Final compensation will be based on experience, licensure, and overall fit for the role.
Equal Opportunity Employer
Bridgecrest Recovery is an Equal Opportunity Employer. We welcome applicants of all backgrounds and do not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other characteristic protected by law. People in recovery are encouraged to apply.