Remote Utilization Management Coordinator I

Elevance Health, Inc.; Meridian (ID); Remote; USD 36,000 - 48,000; Full time

Job summary

Elevance Health is seeking an Utilization Management Representative I to coordinate precertification and prior authorization reviews. This remote role favors candidates located in Meridian, Idaho or within commuting distance, with in-person training sessions as required and flexibility to work from a PulsePoint location.

You will handle calls, verify eligibility, authorize services, and route cases to nurse reviewers when needed.

Qualifications

• Requires HS diploma or GED and 1 year of customer service or call-center experience.
• Equivalent background with education and experience may be considered.
• May require medical terminology familiarity or training.

Responsibilities

• Manage incoming calls and post services claims work.
• Determine contract and benefit eligibility.
• Provide authorizations for inpatient, outpatient precertification, and prior authorization.
• Refer cases requiring clinical review to a Nurse reviewer.
• Respond to inquiries from clients, providers and internal teams.

Skills

Customer service

Medical terminology

Insurance knowledge

Education

High school diploma or GED

Job description

Elevance Health is seeking an Utilization Management Representative I to coordinate precertification and prior authorization reviews. This remote role favors candidates located in Meridian, Idaho or within commuting distance, with in-person training sessions as required and flexibility to work from a PulsePoint location.

You will handle calls, verify eligibility, authorize services, and route cases to nurse reviewers when needed.