Remote Utilization Management Specialist I

Elevance Health; Mars (PA); On-site; USD 42,000 - 60,000; Full time

Job summary

Elevance Health is seeking a Utilization Management Representative I to coordinate precertification and prior authorization reviews. This full-time remote role offers flexibility with required in-person training sessions and optional alternate locations within commuting distance.

You will handle incoming calls and post-service claims work, determine contract and benefit eligibility, and authorize inpatient admissions, precertifications, and post-authorization activities.

Responsibilities

• Managing incoming calls or incoming post services claims work.
• Determines contract and benefit eligibility; provides authorization for inpatient admission, outpatient precertification, prior authorization, and post

Job description

Elevance Health is seeking a Utilization Management Representative I to coordinate precertification and prior authorization reviews. This full-time remote role offers flexibility with required in-person training sessions and optional alternate locations within commuting distance.

You will handle incoming calls and post-service claims work, determine contract and benefit eligibility, and authorize inpatient admissions, precertifications, and post-authorization activities.