Remote Utilization Management Coordinator I

Elevance Health; Indianapolis (IN); Hybrid; USD 22,000 - 25,000; Full time

Benefits offered by this job

401(k) match

Stock purchase plan

Wellness programs

Paid holidays

Job summary

Elevance Health is seeking an Utilization Management Representative I to coordinate precertification and prior authorization reviews. The role supports a hybrid/virtual work model with in-person training sessions and periodic office presence as needed.

Responsibilities include handling calls, verifying eligibility, authorizing services, and coordinating with nurse reviewers. The position requires strong communication, empathy, and multitasking in a fast-paced environment.

Qualifications

• HS diploma or GED.
• Minimum of 1 year of customer service or call-center experience; or any combination of education and experience which would provide an equivalent background.

Responsibilities

• Coordinate cases for precertification and prior authorization review.
• Manage incoming calls and claims work.
• Determine contract and benefit eligibility; provide authorization for inpatient admissions, outpatient precertification, prior authorization, and post-service requests.
• Refer cases requiring clinical review to a Nurse reviewer.
• Enter referral data into the UM system per the plan certificate.
• Respond to inquiries from clients, providers and internal teams.
• Conduct clinical screening and authorize initial set of sessions to providers.

Skills

Customer service

Medical terminology

Education

HS diploma or GED

Job description

Elevance Health is seeking an Utilization Management Representative I to coordinate precertification and prior authorization reviews. The role supports a hybrid/virtual work model with in-person training sessions and periodic office presence as needed.

Responsibilities include handling calls, verifying eligibility, authorizing services, and coordinating with nurse reviewers. The position requires strong communication, empathy, and multitasking in a fast-paced environment.