Remote Utilization Management Representative I

The Elevance Health Companies, Inc.; Columbus (OH); Remote; USD 22,000 - 33,000; Full time

Benefits offered by this job

Comprehensive benefits package

401k contribution

Paid holidays

Paid Time Off

Medical coverage

Dental coverage

Vision coverage

Wellness programs

Job summary

Elevance Health seeks an Utilization Management Representative I to support precertification and prior authorization reviews. The role offers flexible virtual work with required in-person training and occasional office presence, located in Columbus, OH.

Key duties include handling calls, processing referrals, and ensuring timely responses while maintaining high accuracy. A valid HS diploma and at least one year in customer service are preferred.

Qualifications

• Minimum 1 year of customer service or call-center experience.
• Strong verbal and written communication skills.
• Empathy, problem-solving and attention to detail.

Responsibilities

• Manage incoming calls and post services claims work.
• Determine contract and benefit eligibility; authorize in/outpatient requests.
• Refer cases needing clinical review to a Nurse reviewer.
• Enter referral data into the UM system accurately.
• Respond to inquiries from clients, providers and internal teams.
• Perform clinical screening and authorize initial sessions.
• Maintain positive customer relations and coordinate with functions.

Skills

Customer service

Communication

Multitasking

Empathy

Detail oriented

Education

HS diploma or GED

Job description

Elevance Health seeks an Utilization Management Representative I to support precertification and prior authorization reviews. The role offers flexible virtual work with required in-person training and occasional office presence, located in Columbus, OH.

Key duties include handling calls, processing referrals, and ensuring timely responses while maintaining high accuracy. A valid HS diploma and at least one year in customer service are preferred.