Remote Utilization Management Associate I

Elevance Health; Winston-Salem (NC); Hybrid; USD 22,000 - 33,000; Full time

Benefits offered by this job

Stock purchase plan

401(k) contributions

Comprehensive benefits

Job summary

Elevance Health is seeking a Behavioral Health Utilization Management Representative I – Backoffice Support to process approvals and manage documentation in a hybrid, mostly virtual role with some in-person training. You will handle precertifications, authorizations, and post-service requests for government and commercial lines.

The role emphasizes accuracy, confidentiality, and collaboration with clinical reviewers and providers, with shifts between 8:00 a.m. and 8:00 p.m.

Qualifications

• HS diploma or GED with 1 year of customer service or call-center experience or equivalent background.
• Administrative support or back-office experience in healthcare is preferred.
• Familiarity with HIPAA and healthcare privacy requirements preferred.

Responsibilities

• Process precertification, prior authorization, and post-service requests for government and commercial lines.
• Enter referral and authorization data into utilization management systems.
• Prepare and send clear fax correspondence 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 barriers promptly and maintain confidentiality per policies and regulations.

Skills

Customer service

Healthcare ops

Data entry

Job description

Elevance Health is seeking a Behavioral Health Utilization Management Representative I – Backoffice Support to process approvals and manage documentation in a hybrid, mostly virtual role with some in-person training. You will handle precertifications, authorizations, and post-service requests for government and commercial lines.

The role emphasizes accuracy, confidentiality, and collaboration with clinical reviewers and providers, with shifts between 8:00 a.m. and 8:00 p.m.