Remote Utilization Management Associate I

Elevance Health; Atlanta (GA); Hybrid; USD 42,000 - 64,000; Full time

Job summary

Elevance Health is seeking an Utilization Management Representative I - Backoffice Support in the Atlanta area. This back-office role focuses on processing precertification, prior authorization, and post-service requests with no inbound calls, though limited outbound follow-up may be required.

The position requires a HS diploma or GED and at least 1 year of customer service experience. It involves HIPAA/privacy compliance and potential in-person training as part of a hybrid work arrangement.

Qualifications

• Requires HS diploma or GED and at least 1 year of customer service or call-center experience.
• Experience in healthcare or insurance back-office is preferred.
• Ability to understand medical terminology is preferred.

Responsibilities

• Review and process utilization management requests via fax, queues, and approved channels.
• Enter referral and authorization data into utilization management systems accurately.
• Prepare and send clear fax communications to providers, facilities, members, and internal partners.
• Meet productivity, quality, accuracy, and turnaround-time standards with low error rate.
• Document actions and correspondence accurately and completely; escalate as needed.
• Protect confidential information and comply with HIPAA, privacy, and security requirements.

Skills

Administrative support

Healthcare operations

Data entry

Back-office experience

Education

HS diploma or GED

Job description

Elevance Health is seeking an Utilization Management Representative I - Backoffice Support in the Atlanta area. This back-office role focuses on processing precertification, prior authorization, and post-service requests with no inbound calls, though limited outbound follow-up may be required.

The position requires a HS diploma or GED and at least 1 year of customer service experience. It involves HIPAA/privacy compliance and potential in-person training as part of a hybrid work arrangement.