Utilization Review Specialist – Exact Billing Solutions (EBS) 
Lauderdale Lakes, FL - On-site - No Remote

Salary: $55K - $70K

Who We Are 

Exact Billing Solutions is a unique team of revenue cycle management professionals specializing in the substance use disorder, mental health, and autism care fields of healthcare services. We have extensive industry knowledge, a deep understanding of the specific challenges of these markets, and a reputation for innovation. With our proprietary billing process, EBS is the oil that brings life to the engines of its partner healthcare companies. 

EBS is poised for exponential growth, and we are building out our teams to support the expansion of global operations. 

Part of the ICBD family office portfolio, Exact Billing Solutions combines entrepreneurial speed with the financial discipline of a self-funded, founder-led organization. Our growth reflects a proven ability to solve complex healthcare challenges with operational precision, scalable systems, and client-first innovation. 

Our Origin Story 

Exact Billing Solutions was launched to address one of healthcare’s most persistent challenges: the burden of billing and insurance administration on providers. With firsthand knowledge of how inefficiencies in revenue cycle management drain resources from patient care, our founder built a company dedicated to removing obstacles, accelerating cash flow, and delivering peace of mind to clients across specialties. 

Recognition & Awards 

Exact Billing Solutions contributes heavily to the success of the broader ICBD family office ecosystem and benefits from the recognition awarded to other portfolio companies, including: 

• Inc. 5000, 2024 – Top 5 Fastest-Growing Private Companies in America (ABA Centers of America) 

• EY Entrepreneur Of The Year® U.S. Overall 

• Florida Trend Magazine – 500 Most Influential Business Leaders

Requirements

About the Role

As a Utilization Review Specialist, you will play a pivotal role in ensuring the efficient and effective utilization of healthcare resources. You will be responsible for reviewing and evaluating clinical documentation, treatment plans, and medical records to optimize patient care and streamline healthcare delivery processes.

The principal functions of the position identified shall not be considered as a complete description of all the work requirements and expectations that may be inherent in the position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the position.

Key Responsibilities

The following are duties and responsibilities that the Utilization Review Specialist shall provide:

Clinical Documentation Review:

• Evaluate and analyze medical records, treatment plans, and clinical documentation to ensure accuracy and compliance with established standards.
• Collaborate with healthcare providers to gather additional information or clarification on documentation when necessary.

Utilization Review:

• Assess the appropriateness and necessity of healthcare services, ensuring they align with established guidelines and policies.
• Identify and communicate potential issues related to overutilization or underutilization of services.

Collaboration and Communication:

• Work closely with interdisciplinary teams, Board Certified Behavior Analysts, Registered Behavior Technicians, and other healthcare professionals to gather insights and ensure comprehensive reviews.
• Communicate findings and recommendations clearly and effectively to internal teams and external stakeholders.

Quality Improvement:

• Participate in quality-improvement initiatives to enhance the overall efficiency and effectiveness of healthcare delivery.
• Provide feedback and suggestions for process improvements based on review findings.

Regulatory Compliance:

• Stay informed on relevant healthcare regulations, guidelines, and accreditation standards.
• Ensure compliance with all applicable laws and regulations in the utilization review process.

Qualifications

The Utilization Review Specialist requires a minimum of a(n):

• Bachelor's degree in a healthcare-related field (Social Work, Mental Health Counseling, Physical Therapy, Occupational Therapy, Speech-Language Pathology, Nursing); Master's degree preferred.
• Relevant clinical licensure or certification (e.g., BCBA, LSW, LMHC, PT, OT, SLP, RN).
• Proven experience in utilization review or a related field with a strong understanding of healthcare service delivery and documentation processes is highly desirable.
• Up-to-date knowledge of relevant healthcare regulations, guidelines, and accreditation standards.
• Understanding of compliance requirements and the ability to ensure adherence during the utilization review process.
• Must maintain clean background/drug screenings and driving record

Expertise Needed

• Familiarity with industry standards, guidelines, and best practices related to utilization review.
• Ability to analyze complex clinical documentation, treatment plans, and medical records.
• Strong critical thinking skills to assess the appropriateness and necessity of healthcare services.
• Strong analytical and critical thinking skills.
• Excellent communication and interpersonal skills.
• Ability to work collaboratively in a team-oriented environment.

Benefits

• 21 paid days off (15 days of PTO, which increases with tenure, plus 6 holidays).  

• Flexible Spending Account (FSA) and Health Savings Account (HSA) options.  

• Medical, dental, vision, long-term disability, and life insurance.  

• Generous 401(k) with up to 6% employer match.  

Exact Billing Solutions (EBS) Culture 

Integrity. Dependability. Attention to detail. All our team members exhibit these qualities when it comes to doing business. And when it comes to the business of supporting a team, as a company, we offer no less to our team members. We’re a fast-paced, growing company delivering services that allow our clients to spend more time helping people. At the end of the day, it’s people, not numbers, that drive our success. 

Exact Billing Solutions participates in the U.S. Department of Homeland Security E-Verify program.