Remote Utilization Management Associate I

Elevance Health (Anthem); Columbus (OH); Remote; USD 22,000 - 33,000; Full time

Benefits offered by this job

Comprehensive benefits package

401k contribution

Equity stock purchase program

Incentive and recognition programs

Job summary

Elevance Health (Anthem) is seeking an Utilization Management Representative I to support virtual operations. You will handle calls and post-service claims, determine eligibility, and authorize initial treatment sessions while collaborating with nurses and internal teams.

Flexibility includes occasional in-person onboarding and potential office days. The role emphasizes patient and provider communication, data entry accuracy, and the ability to multi-task in a fast-paced environment with

Qualifications

• HS diploma or GED required.
• Minimum of 1 year in customer service or call center environment.

Responsibilities

• Handling incoming calls and post services claims work.
• Determines contract and benefit eligibility; approves inpatient/outpatient authorizations and post-service requests.
• Refers complex cases to a Nurse reviewer for clinical review.
• Enters referral requests into the UM system per plan certificate.
• Responds to inquiries from clients, providers and internal teams.

Skills

Customer service

Education

High School Diploma or GED

Job description

Elevance Health (Anthem) is seeking an Utilization Management Representative I to support virtual operations. You will handle calls and post-service claims, determine eligibility, and authorize initial treatment sessions while collaborating with nurses and internal teams.

Flexibility includes occasional in-person onboarding and potential office days. The role emphasizes patient and provider communication, data entry accuracy, and the ability to multi-task in a fast-paced environment with