Authorization for inpatient and outpatient services
Data entry of referral requests
The Utilization Management Representative I is responsible for coordinating cases for precertification and prior authorization review, ensuring timely and accurate authorization decisions
Job Summary
The Utilization Management Representative I is responsible for coordinating cases for precertification and prior authorization review, ensuring timely and accurate authorization decisions.
Elevance Health offers a flexible virtual work environment with required in-person training and promotes a culture focused on personal and professional growth.
The company provides a comprehensive total rewards package including merit increases, paid holidays, medical and dental benefits, 401(k) match, and wellness programs.
Matching Summary
The Utilization Management Representative I is responsible for coordinating cases for precertification and prior authorization review, ensuring timely and accurate authorization decisions.
Skills & Requirements
Must-have
Managing incoming calls and claims work
Authorization for inpatient and outpatient services
Data entry of referral requests
Multi-tasking in fast-paced environment
Strong verbal and written communication skills
Proficient with digital tools and platforms
Nice-to-have
Experience in mental health or behavioral health
Empathy and persistence in customer service
Problem-solving and critical thinking skills
Facilitation and analytical skills
Comfort with virtual and in-person interactions
Key Requirements
High school diploma or GED
Minimum 1 year customer service or call-center experience
Experience in mental health, behavioral health, substance abuse, or Medicaid preferred