Salary Range: $80,000 - $110,000 Job Posting End Date: March 16th 2026 We’ve Got You Under Our Wing We are the duck. We develop and empower our people, cultivate relationships, give back to our community, and celebrate every success along the way. We do it all…The Aflac Way. Aflac, a Fortune 500 company, is an industry leader in voluntary insurance products that pay cash directly to policyholders and one of America's best-known brands. Aflac has been recognized as Fortune’s 50 Best Workplaces for Diversity and as one of World’s Most Ethical Companies by Ethisphere.com. Our business is about being there for people in need. So, ask yourself, are you the duck? If so, there’s a home, and a flourishing career for you at Aflac. Worker Designation – This role is a remote role. This means you will be expected to work from your home, within the continental US. If the role is remote, there may be occasions that you are requested to come to the office based on business need. Any requests to come to the office would be communicated with you in advance. What does it take to be successful at Aflac? - Acting as a Champion for Change - Acting with Integrity - Communicating Effectively - Demonstrating Initiative - Developing Talent - Managing Performance - Pursuing Self-Development - Serving Customers - Supporting Change - Supporting Organizational Goals - Working with Diverse Populations What does it take to be successful in this role? • Broad knowledge of production management concepts, operating principles, and operational management methodology applicable to claims processing; a high degree of skill in applying this knowledge to the analysis and resolution of very complex or sensitive claims operational issues; ability to apply new developments and methodologies to direct the improvement in efficiencies • Broad knowledge of federal, state, and local regulatory and industry requirements, standard concepts, practices, and procedures as they relate to the insurance industry and claims processing • Knowledge of budgeting and expense control to plan, implement, and maximize expenditure of funds while maintaining and improving quality standards • Knowledge of employee relations to conduct and deal with employee issues in a proactive manner • Strong personal computer skills with experience in Windows-based software; experience using Microsoft Outlook or a similar e-mail system software • Excellent presentation, oral, written, and interpersonal communications skills to effectively interact with senior management, and internal and external business contacts Education & Experience Required - Bachelor's Degree In business or a related field - 6 years of job-related work experience. - 4 years in a leadership/senior/supervisory capacity. Or an equivalent combination of education and experience Education & Experience Preferred - Absence & Disability Industry Experience (STD/FMLA) - Industry designations such as FLMI or ALHC. Principal Duties & Responsibilities • Manages the daily operations of the Claims business unit; manages employees and operations of the business unit at the functional level; gathers and analyzes data and reports that pertain to the overall operation of the Claims business unit and completes reports summarizing activities and trends; assists in strategic and tactical operational plans to ensure achievement of company and departmental goals; performs independent review of problem situations; develops solutions and implements actions to resolve problems and ensure customer satisfaction; reviews processes and procedures to streamline activities to enhance service turnaround time, productivity, and quality; coordinates overall workflow of the business unit and ensures that workflow processes facilitate effective and efficient use of corporate resources and enhance customer satisfaction • Directs efforts to implement risk management and quality improvement initiatives; facilitates calibration sessions; uses methods such as work process studies, statistical analysis, and assessments of production area performance to establish adherence to quality standards/scorecards; remains abreast of industry trends and technology changes; incorporates best practices in the development of quality standards, policies, programs, and system changes for the department; ensures that claims are processed according to appropriate risk selection principles • Coordinates and monitors training efforts to ensure that necessary education tools are provided to employees; identifies and communicates training needs and schedules with training department; projects staffing requirements for the business unit; guides supervisors in coaching and counseling employees; coordinates employee development and incentive initiatives • Identifies, analyzes, and monitors business technology requirements and enhancement possibilities; recommends viable technological solutions, modifications, and applications; prepares recommendations for implementation of initiatives; takes a leadership role in managing assigned initiatives; participates in and supports companywide initiatives through Quality Circles, Focus Groups, or other project initiatives • Monitors and controls operating expenses to ensure that corporate/divisional financial goals are met; provides input into the annual business unit budget; reviews legal files and coordinates with counsel to prepare for depositions and court hearings • Performs other related duties as required Total Rewards The salary range for this job is $80,000 to $110,000. This range is specific to the job and salary offers consider a wide range of factors that are considered in making compensation decisions, including, but not limited to: education, experience, licensure, certifications, geographic location, and peer compensation. The range has been created in good faith based on information known to Aflac at the time of the posting. At Aflac, it is not typical for an individual to be hired at or near the top of the range for the role to allow for future and continued salary growth, and compensation decisions are dependent on the circumstances of each case. This salary range does not include any potential incentive pay or benefits, however, such information will be provided separately when appropriate. In addition to the base salary, we offer an array of benefits to meet your needs including medical, dental, and vision coverage, prescription drug coverage, health care flexible spending, dependent care flexible spending, Aflac supplemental policies (Accident, Cancer, Critical Illness and Hospital Indemnity offered at no costs to employee), 401(k) plans, annual bonuses, and an opportunity to purchase company stock. On an annual basis, you’ll also be offered 11 paid holidays, up to 20 days PTO to be used for any reason, and, if eligible, state-mandated sick leave (Washington employees accrue 1-hour sick leave for every 40 hours worked) and other leaves of absence, if eligible, when needed to support your physical, financial, and emotional well-being. Aflac complies with all applicable leave laws, including, but not limited to, sick and safe leave, and adoption and parental leave, in all states and localities.

Anticipated End Date: 2026-03-21 Position Title: Grievance/Appeals Representative I (Florida Only) Job Description: Grievance/Appeals Representative I (Florida) Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The Grievance/Appeals Representative I will be responsible for reviewing, analyzing and processing claims in accordance with policies and claims events to determine the extent of the company's liability and entitlement. How you will make an impact: ​ - Conducts investigation and review of customer grievances and appeals involving provision of service and benefit coverage issues. - Contacts customers to gather information and communicate disposition of case. - Documents interactions. - Generates written correspondence to customers such as members, providers and regulatory agencies. - Performs research to respond to inquiries and interprets policy provisions to determine the extent of company's liability and/or provider's/beneficiaries entitlement. - Responds to appeals from CS Units, Provider Inquiry Units, members, providers and/or others for resolution or affirmation of previously processed claims. - Ensures appropriate resolution to inquiries, grievances and appeals within specified timeframes established by either regulatory/accreditation agencies or customer needs. - Identifies barriers to customer satisfaction and recommends actions to address operational challenges. Minimum Requirements - HS diploma or equivalent. - Minimum of 1 year experience in health insurance business including customer service experience; or any combination of education and experience which would provide an equivalent background. Preferred Skills, Capabilities and Experiences - Good verbal and written communication, organizational, interpersonal skills and PC proficiency strongly preferred. Job Level: Non-Management Non-Exempt Workshift: 1st Shift (United States of America) Job Family: CLM > Claims Support Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act. Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.

Welcome! We’re excited you’re considering an opportunity with us! To apply to this position and be considered, click the Apply button located above this message and complete the application in full. Below, you’ll find other important information about this position. Come join our Peak Health team at WVU Medicine as a Medicare Enrollment Specialist, contributing to the foundation for an innovative, new health plan. This position will report to the Enrollment Manager, playing a unique and important role in our mission to change healthcare for the better. Experience in Medicare and critical thinking skills will help the organization build an effective and efficient enrollment team. The enrollment team will review, execute, and oversee the processing of member enrollment application information for Peak Health’s Plan Suite. The Medicare Enrollment Specialist will analyze and process enrollment forms, checking for validity, completion, and accuracy. Ability to determine whether to enroll, outreach, or reject applications while following organizational policies and procedures is a must. This job reviews and evaluates all documents for quality control for final entry of member enrollment forms. MINIMUM QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: 1. High School diploma or equivalent EXPERIENCE: 1. Two (2) year of experience working with medical or institutional data entry. 2. Two (2) year of customer service experience. OR One (1) year of Medicare eligibility and Medicare Enrollment processing experience PREFERRED QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: 1. Associate Degree, or greater, in related healthcare field. EXPERIENCE: 1. Three (3) to five (5) years of Medicare Enrollment processing and customer service experience. 2. Two (2) years of experience with Medicare elections, transaction codes, and reconciliation operations. 3. Two (2) years managing late enrollment penalty (LEP) for MAPD enrollees. 4. Familiarity with navigating CMS tools and resources, particularly the MARx website. 5. At least one (1) year of experience with system/user acceptance testing. 6. At least one (1) year of experience with developing and delivering trainings. CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned. 1. Determine accuracy and completions of member form information. Entry/verifies form data. 2. Resolves enrollment issues to assure efficient and seamless member experience. 3. Maintains Medicare member enrollment records annually, indicating changes, updates, and outreach as required. 4. Meets all production and quality standards, maintaining Workqueues according to department standards. 5. Effectively communicates with internal and external staff. 6. Elevates issues to next level of supervision, as appropriate. 7. Ensures accuracy of data entered and record maintenance. 8. Attends all required training classes, demonstrating proficiency and ability to learn. 9. Manages coordination of benefits (COB) on member records. 10. Develops and Delivers department trainings to new hires. 11. Participates in system testing for any development rollouts. 12. Participates in department planning to ensure a successful Open Enrollment. 13. Other duties as deemed appropriate by the Management Team. 14. Processes SNP applications, verifying eligibility, including but not limited to Dual-Entitlement and residence within the service area. PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 1. Ability to sit for extended periods of time. WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 1. Standard office environment with electrical equipment (i.e., telephone, personal computer, copier, fax machines, etc.) 2. Computer Software/Systems include but not limited to Microsoft Office Professional Suite (Outlook, Word, Excel, Access), Internet Explorer, and EPIC. SKILLS AND ABILITIES: 1. Familiarity with Medical insurance enrollment processes. 2. Working Knowledge of administrative and clerical procedures and systems such as word processing and managing files and records. 3. Ability to take direction and to navigate through multiple systems simultaneously. 4. Excellent written and oral communication, customer service, interpersonal skills, and telephone etiquette skills. 5. Ability to solve problems with predefined methods and guidelines to drive improved efficiencies and customer satisfaction. 6. Requires exceptional attention to detail, the ability to be organized and to be able to perform multiple tasks simultaneously. Additional Job Description: Scheduled Weekly Hours: 40 Shift: Exempt/Non-Exempt: United States of America (Non-Exempt) Company: PHH Peak Health Holdings Cost Center: 2902 PHH Claims Operations

Anticipated End Date: 2026-04-16 Position Title: Utilization Management Representative I Job Description: Utilization Management Rep I-Care Support Location: Tampa, FL or Miami, FL Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions (when indicated), providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The Utilization Management Representative I is responsible for coordinating cases for precertification and prior authorization review. How you will make an impact: - Managing incoming calls or incoming post services claims work. - Determines contract and benefit eligibility; provides authorization for inpatient admission, outpatient precertification, prior authorization, and post service requests. - Refers cases requiring clinical review to a Nurse reviewer. - Responsible for the identification and data entry of referral requests into the UM system in accordance with the plan certificate. - Responds to telephone and written inquiries from clients, providers and in-house departments. Conducts clinical screening process. - Authorizes initial set of sessions to provider. - Checks benefits for facility-based treatment. - Develops and maintains positive customer relations and coordinates various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner. - Associates in this role are expected to have the ability to multi-task, including handling calls, texts, facsimiles, and electronic queues, while simultaneously taking notes and speaking to customers. - Additional expectations to include but not limited to: Proficient in maintaining focus during extended periods of sitting and handling multiple tasks in a fast-paced, high-pressure environment; strong verbal and written communication skills, both with virtual and in-person interactions; attentive to details, critical thinker, and a problem-solver; demonstrates empathy and persistence to resolve caller issues completely; comfort and proficiency with digital tools and platforms to enhance productivity and minimize manual efforts. - Associates in this role will have a structured work schedule with occasional overtime or flexibility based on business needs, including the ability to work from the office as necessary. - Performs other duties as assigned. Minimum requirements: - Requires HS diploma or GED and a minimum of 1 year of customer service or call-center experience; or any combination of education and experience which would provide an equivalent background. Preferred Skills, Capabilities and Experiences: - Medical terminology training and experience in medical or insurance field preferred. - A minimum of one to two years of experience in a high-volume medical front office, hospital administration, or insurance verification environment is preferred. Job Level: Non-Management Non-Exempt Workshift: Job Family: CUS > Care Support Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act. Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.