UM Services Representative I — Authorization & Care Support

Excellus BCBS; Town of De Witt (NY); Remote; USD 28,000 - 37,000; Full time

Job summary

Excellus BCBS is seeking a dedicated UM Services Clerk to support utilization management workflows with administrative and customer service duties. The role involves handling calls, authorizations via multiple tools, and collaboration with providers and members across regulatory guidelines.

The position emphasizes strong organizational skills, accurate processing, and commitment to protecting member privacy. Remote work may be available on a case-by-case basis within the New York service area.

Qualifications

• High School Diploma or GED required.
• Experience in a professional desktop environment; MS Office preferred.
• Call center experience preferred but not required.

Responsibilities

• Handle inbound and outbound calls to members and providers in a call center setting.
• Provide timely authorizations via phone, Care Advance Provider Tool, and fax.
• Coordinate with departments to ensure end-to-end authorization and notification processes.
• Maintain member privacy and adhere to regulatory timeframes.
• Support UM Services with scheduling, training, and process improvements.

Skills

Customer service

Communication

Problem solving

Organizational skills

Teamwork

Education

High School Diploma or GED

Tools

FACETS

PEGA

Job description

Excellus BCBS is seeking a dedicated UM Services Clerk to support utilization management workflows with administrative and customer service duties. The role involves handling calls, authorizations via multiple tools, and collaboration with providers and members across regulatory guidelines.

The position emphasizes strong organizational skills, accurate processing, and commitment to protecting member privacy. Remote work may be available on a case-by-case basis within the New York service area.