Remote Utilization Management Rep III

Anthem Blue Cross & Blue Shield; Columbus (GA); Remote; USD 54,000 - 64,000; Full time

Job summary

Elevance Health is hiring a Utilization Management Representative III for a Columbus, GA role that can be performed remotely with occasional in-person sessions. The candidate will coordinate precertification and prior authorization reviews and provide guidance to UM Reps on eligibility issues.

Ideal applicants bring 3+ years in healthcare customer service, strong communication and problem-solving skills, and empathy to resolve caller concerns while navigating complex benefit rules.

Qualifications

• HS diploma or GED.
• 3+ years of healthcare customer service experience or equivalent background.
• Knowledge of health plans and prior authorization preferred.

Responsibilities

• Coordinate cases for precertification and prior authorization review.
• Provide technical guidance to UM Reps and assist callers with eligibility issues.
• Identify improvement areas and take on new projects as assigned.
• Handle escalated calls and direct reps to appropriate resources.
• Explain workflow, processes, priorities and guidelines clearly.
• Assist in new hire training as a potential proxy for Ops Expert.
• Demonstrate core values and maintain focus in a fast-paced environment.
• Multitask across calls, texts, and queues while taking notes and speaking with customers.
• Work flexible schedules including overtime and in-office time when needed.

Skills

Customer service

Healthcare knowledge

Communication skills

Problem solving

Multitasking

Empathy

Education

HS diploma

Job description

Elevance Health is hiring a Utilization Management Representative III for a Columbus, GA role that can be performed remotely with occasional in-person sessions. The candidate will coordinate precertification and prior authorization reviews and provide guidance to UM Reps on eligibility issues.

Ideal applicants bring 3+ years in healthcare customer service, strong communication and problem-solving skills, and empathy to resolve caller concerns while navigating complex benefit rules.