Remote Utilization Management Associate I - Backoffice

Elevance Health (Anthem); Las Vegas (NV); Hybrid; USD 23,000 - 39,000; Full time

Job summary

Elevance Health seeks an Utilization Management Representative I - Backoffice Support to process precertifications, prior authorizations, and post-service requests for governmental and commercial lines. This is a backoffice role with limited outbound calls and optional in-person training as needed.

The role requires a HS diploma or GED and at least 1 year of customer service experience. You will work a hybrid schedule with potential East Coast hours and must maintain HIPAA compliance and

Qualifications

• Requires HS diploma or GED and a minimum of 1 year of customer service or call-center experience.
• Medical terminology training and experience in medical or insurance field preferred.
• Proficiency with computers, electronic work queues, email, and document-management systems preferred.

Responsibilities

• Reviews and processes utilization management requests received through fax, electronic queues, and other approved channels.
• Accurately enters referral and authorization information into utilization management systems.
• Prepares and sends clear, complete, and accurate fax correspondence to providers, facilities, members, and internal partners.

Skills

Customer service

Data entry

Medical terminology

Communication skills

Problem solving

Analytical skills

Self-management

Education

HS diploma or GED

Tools

Document-management systems

Email

Job description

Elevance Health seeks an Utilization Management Representative I - Backoffice Support to process precertifications, prior authorizations, and post-service requests for governmental and commercial lines. This is a backoffice role with limited outbound calls and optional in-person training as needed.

The role requires a HS diploma or GED and at least 1 year of customer service experience. You will work a hybrid schedule with potential East Coast hours and must maintain HIPAA compliance and