UM Services Support Specialist I

Excellus BlueCross BlueShield; Town of De Witt (NY); On-site; USD 28,000 - 37,000; Full time

Benefits offered by this job

Remote work possibility

Job summary

Excellus BlueCross BlueShield is seeking an individual to support Utilization Management (UM) workflows by providing administrative support and customer service. The role handles inbound/outbound calls, creates authorizations via phone and Care Advance Provider Tool, and processes fax requests for inpatient/outpatient, behavioral health, and durable medical equipment.

Levels I-III expand responsibilities to project support, coaching, and collaboration with Claims, Customer Service, and care

Qualifications

• High School Diploma or GED.
• Experience with using a desktop computer in a professional environment, preferably with Microsoft Office Products.
• Call center experience preferred, not required.
• Strong analytical and problem-solving skills.
• Strong written and verbal communication skills and ability to work within a team.
• Demonstrated organizational skills to manage multiple projects and priorities.
• Self-motivated and able to work independently, as well as on intra- and inter-departmental teams where needed.

Responsibilities

• Facilitates inbound and outbound calls to customers (members and providers) by delivering excellent customer-centered service providing information regarding services in a call center environment.
• Responds to customers in a professional, efficient manner to encourage public acceptance of products, services, and policies.
• Perform triage for UM Services.
• Serves as the primary contact for providers regarding authorization requests.

Skills

Customer service

Call center

Analytical skills

Teamwork

Written/verbal communication

Education

High School Diploma or GED

Tools

Microsoft Office

FACETS

PEGA

Care Advance Provider Tool

Job description

Excellus BlueCross BlueShield is seeking an individual to support Utilization Management (UM) workflows by providing administrative support and customer service. The role handles inbound/outbound calls, creates authorizations via phone and Care Advance Provider Tool, and processes fax requests for inpatient/outpatient, behavioral health, and durable medical equipment.

Levels I-III expand responsibilities to project support, coaching, and collaboration with Claims, Customer Service, and care