Remote Utilization Management Specialist II

elevancehealth; Mason (OH); Hybrid; USD 42,000 - 62,000; Full time

Job summary

Elevance Health seeks an Utilization Management Representative II to manage incoming calls, triage cases, open files and authorize sessions in a fast-paced healthcare setting.

This role supports clinical review processes, requires a HS diploma and healthcarecustomer service experience with medical terminology training. The position offers hybrid/remote work with in-person training at designated locations.

Qualifications

• Requires HS diploma or equivalent and a minimum of 2 years customer service experience in healthcare related setting or related education/experience.
• Medical terminology training is preferred.
• Intermediate to strong communication skills and ability to work with diverse teams.

Responsibilities

• Handle incoming calls and triage, opening cases and authorizing sessions.
• Determine contract and benefit eligibility; provide inpatient/outpatient authorization and post-service requests.
• Obtain intake information from callers and verify benefits/eligibility.

Skills

Customer service

Medical terminology

Communication

Excel

Education

HS diploma or equivalent

Medical terminology training

Job description

Elevance Health seeks an Utilization Management Representative II to manage incoming calls, triage cases, open files and authorize sessions in a fast-paced healthcare setting.

This role supports clinical review processes, requires a HS diploma and healthcarecustomer service experience with medical terminology training. The position offers hybrid/remote work with in-person training at designated locations.