Remote Utilization Management Associate I

Anthem Blue Cross & Blue Shield; Columbus (GA); On-site; USD 38,000 - 52,000; Full time

Job summary

Elevance Health is seeking a Utilization Management Representative I to coordinate precertification and prior authorization reviews. The role supports virtual, full-time work with occasional in-person training aligned to standard onboarding processes.

The position emphasizes handling calls, verifying benefits, and entering referrals into the UM system while maintaining strong customer relations and compliant processes. Strong communication is essential.

Qualifications

• HS diploma or GED required.
• Minimum of 1 year of customer service or call-center experience; equivalent background accepted.

Responsibilities

• Manage incoming calls and post-service claims work.
• Determine contract and benefit eligibility; authorize inpatient/outpatient precertification and post-service requests.
• Refer cases for clinical review to a nurse reviewer.
• Enter referral data into the UM system per plan certificate.
• Respond to inquiries from clients, providers and internal teams.

Skills

Customer service

Call center

Medical terminology

Education

HS diploma or GED

Job description

Elevance Health is seeking a Utilization Management Representative I to coordinate precertification and prior authorization reviews. The role supports virtual, full-time work with occasional in-person training aligned to standard onboarding processes.

The position emphasizes handling calls, verifying benefits, and entering referrals into the UM system while maintaining strong customer relations and compliant processes. Strong communication is essential.