Utilization Management Specialist II - Onsite San Antonio

Elevance Health; San Antonio (TX); On-site; USD 40,000 - 60,000; Full time

Job summary

Elevance Health is hiring an Utilization Management Representative II in San Antonio to handle triage, case openings, and session authorizations. This role supports face-to-face collaboration at the posted location and operates on a full-time schedule.

The position requires an HS diploma and healthcare customer service experience, with preference for knowledge of health plans and prior authorization processes. The role is based at 4751 Hamilton Wolf Rd, Ste 101, San Antonio, TX.

Qualifications

• Requires HS diploma or equivalent and at least 2 years of healthcare customer service experience.
• Familiarity with health plans, prior authorization and precertification processes preferred.
• Experience in high-volume environments preferred.

Responsibilities

• Manages incoming calls and triage; opens cases and assigns appropriate workflows.
• Determines contract and benefit eligibility; authorizes inpatient, outpatient precertification, and post-service requests.
• Obtains demographic information from callers and gathers information for review.
• Conducts referrals for nurse review and specialty care as needed.
• Verifies benefits and eligibility; responds to inquiries from clients and providers.

Skills

Customer service

Healthcare knowledge

Communication skills

Clinical terminology

Education

HS diploma or equivalent

Job description

Elevance Health is hiring an Utilization Management Representative II in San Antonio to handle triage, case openings, and session authorizations. This role supports face-to-face collaboration at the posted location and operates on a full-time schedule.

The position requires an HS diploma and healthcare customer service experience, with preference for knowledge of health plans and prior authorization processes. The role is based at 4751 Hamilton Wolf Rd, Ste 101, San Antonio, TX.