Work Schedule: Monday-Friday 11:30 AM – 8:00 PM Mountain Standard Time (MST) Assists in the physician advisor process for cases sent for peer-to-peer review. Supports the scheduling of reviews, communicating the results and completing the required verbal and written correspondence. Provides non-clinical support to workflows involving utilization management. Performs outreach contact to providers and written notification to providers and members for initial determinations. Consults with internal departments to ensure cases meet guidelines. Researches cases referred to peer review and contacts the facility to schedule a physician-to-physician review. Documents task completion in applicable internal systems. Maintains the integrity of the company relationship with stakeholders by researching and responding to provider needs. Identifies risk situations and escalates to supervisor as appropriate. Achieves and maintains department and individual performance standards. Prepares administrative, approval and clinical denial letters as assigned. Reviews completed denial letters to ensure accuracy, template use and within the appropriate grade level. Troubleshoots issues noted on letters by coordinating with team members and physicians to ensure clear and accurate letters. Completes data validation for data entry on letters (address, dates, and other fields as applicable). Assumes responsibility for self-development, career progression and ongoing training to ensure accuracy of work. Assists in the mentoring and training of new UM Support Specialists. Coordinates and manages distribution of correspondence and materials to enrollees and providers. Participates in operational activities, including data collection, tracking, and analysis. The job duties listed above are representative and not intended to be all-inclusive of what may be expected of an employee assigned to this job. A leader may assign additional or other duties which would align with the intent of this job, without revision to the job description. Other Job Requirements Responsibilities Understands health plan benefit structures. Familiarity with psychiatric/medical terminology. Strong verbal and written communications skills. Possesses initiative and interpersonal effectiveness Is personally accountable and adaptable. Is effective at building strong interpersonal work relationships. General Job Information Title Utilization Management Support Specialist I Grade 19 Work Experience - Required Healthcare Work Experience - Preferred Education - Required Education - Preferred Associate License and Certifications - Required License and Certifications - Preferred Salary Range Salary Minimum: $37,725 Salary Maximum: $56,595 This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing. Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.

At SimplyInsured we are on a mission to eliminate fear in health insurance. Health insurance is complicated, expensive, and really important - so it tends to create fear for most people; our goal is to reduce that fear as much as possible. We specifically work with small business owners who have the enormous task of purchasing the right type of insurance for their employees and their families. With more than 20,000 customers and several major partnerships, including NetSuite, Toast ,and Square, we're growing quickly and disrupting this convoluted and confusing industry by making it more transparent and fully accessible to everyone. We got our start in the Y-Combinator incubator, and have been funded by top-tier investors at Polaris Partners, Bessemer Venture Partners, New York Life Ventures and AltaIR Capital. Job Summary: In this role, you will be a member of a high-performing team providing service for SimplyInsured customers. This role will help our customers via chat, phone, and email and serve as a trusted representative of the SimplyInsured brand carrying out the mission of eliminating fear from health insurance. Must be available to work 8:30am -5pm CST Monday-Friday. What you’ll do: Assist potential customers with navigating our online insurance shopping experience and obtaining quotes for their company’s health insurance options. Work with existing customers to answer and resolve basic administrative and billing questions. Your main goal will be to ensure that customer inquiries are responded to quickly and thoroughly. You will contribute daily to the Support team’s mission to delight our customers and help eliminate the fear of purchasing and using health insurance. In this role, you'll use multiple communication channels, including phone, chat, and email, to communicate with customers and our support ticketing software to document customer interactions. You should be passionate about helping customers and love working in a start-up environment. Being on our customer service team’s front lines means you'll have unique insight and access to our customers' issues. You will be empowered to propose process and product solutions to improve our customer experience. What you’ll bring: Compensation: The base salary range for this position is $15.00 per hour Our Culture: We value radical transparency, feedback, bias to action, growth, and an obligation to dissent. Every opinion is respected, we hold each other to extremely high standards, we're driven by the diversity in our backgrounds, and unified by 100% alignment on our mission. Research shows that candidates from underrepresented backgrounds often don't apply for roles if they don't meet all the criteria. We strongly encourage you to apply if you're interested; we'd love to learn how you can amplify our team with your unique experience! We are an equal-opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status. #LI-Remote **SimplyInsured is hiring only in the United States at this time**

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description The Telehealth Technician will play a key role in developing, launching, and scaling a company-wide video assessment program while supporting daily injury management operations. This position blends program coordination, telehealth visit facilitation, real-time injury call support, and data management. The ideal candidate is proactive, highly organized, and adaptable, with the ability to operate effectively in a fast-paced, evolving environment. - Schedule, coordinate, and facilitate telehealth appointments via phone and/or video conference between injured workers, technicians, clinics, and clients - Work closely with dispatch to determine the need for physical technician responses - Accurately document telehealth encounters and outcomes in shared Google Sheets/spreadsheets and internal systems - Identify process improvements and help develop standard operating procedures, training materials, and rollout plans for the expanding telehealth program - Collaborate with leadership to scale the program company-wide (new regions, new client integrations, etc.) - Assist the Injury Dept in technician injury call-ins during business hours and assigned on-call shifts - Provide real-time guidance to field technicians on injury protocols, extended ETAs, and telehealth alternatives - Attend departmental and program meetings - Maintain clear, professional communication with technicians, clients, clinic partners, and internal teams - Adapt quickly to shifting priorities as the company and telehealth program grow Qualifications - Prior experience facilitating telehealth visits via phone and/or video Requirements - Participate in a rotating on-call schedule: minimum of one weeknight per week and one full weekend per month (Friday 4:00 PM PST – Monday 6:00 AM PST). Additional shifts may occasionally be required during staffing changes or high volume periods - Strong proficiency in Google Workspace (Sheets, Docs, Calendar) - Excellent written and verbal communication skills - Ability to remain calm and professional in urgent situations - Strong attention to detail and documentation accuracy - Reliable high-speed internet and a distraction-free home office - Availability during standard business hours (Monday–Friday) with required on-call participation - Flexibility to adjust schedule as needed for program support Benefits - Full-time, hourly position with benefits - Compensation: $17.00-$22.00 per hour, based on experience Location Fully Remote Disclaimer This job description is a summary of basic functions of the position, not an exhaustive or comprehensive list of all possible job responsibilities, tasks, and duties. The responsibilities, tasks, and duties of this position might differ from those outlined in the job description, and other duties, as assigned, might be part of the job to meet business or organization needs.

It’s a great time to join AAA The Auto Club Group! JOIN THE TEAM COMMITTED TO DRIVING YOUR CAREER FORWARD Job Type: Full time Exempt/Non Exempt: Hourly Job Description: Michigan Claim Support Processor - Meemic *** Candidates must reside within 50 miles of Auburn Hills, MI for hybrid purposes. What you will do The Auto Club Group is seeking prospective Claim Support Processor who can provide daily support to the Claim department by completing well defined clerical tasks that require a general understanding of the Claims process, business context and the Claims department organization and workflow. Day-to-day routine tasks include: Research and proper routing of mail, data entry of key information into claim systems for proper routing of documents including summons and complaints Oversight for exception process of RPA functions, ordering police reports and paying low dollar, high volume invoices, generally associated with claim expenses, including research to ensure no payment duplication Request and track retrieval requests for paper files when needed, daily oversight for manual printing, logging, and mailing remotely printed checks for multiple claim systems Receive inbound and make outbound customer phone calls to resolve claims needs Triage phone line as well as a customer care line to answer questions from members or body shops related to inspection assignment Work requires detailed compliance to specific instructions, with supervisory oversight May be assigned tasks normally handled at a higher level as needed Assign claims to claim handlers following prescribed business rules Update claim systems with information related to assigned recovery tasks Supervisory Responsibilities (briefly describe, if applicable, or indicate None) None Work Environment This position is currently able to work remotely from a home office location for day-to-day operations unless occasional travel for meetings, collaborative activities, or team building activities is specified by leadership. This is subject to change based on amendments and/or modifications to the ACG Flex Work policy. How will you benefit A competitive hourly salary between $16.42. to $19.71 ACG offers excellent and comprehensive benefits packages, including: Medical, dental and vision benefits 401k Match Paid parental leave and adoption assistance Paid Time Off (PTO), company paid holidays, CEO days, and floating holidays Paid volunteer day annually Tuition assistance program, professional certification reimbursement program and other professional development opportunities AAA Membership Discounts, perks, rewards, and much more We’re looking for candidates wh o: Required Qualifications (these are the minimum requirements to qualify): To learn more about AAA The Auto Club Group visit www.aaa.com Important Note: ACG’s Compensation philosophy is to provide a market-competitive structure of fair, equitable and performance-based pay to attract and retain excellent talent that will enable ACG to meet its short and long-term goals. ACG utilizes a geographic pay differential as part of the base salary compensation program. Pay ranges outlined in this posting are based on the various ranges within the geographic areas which ACG operates. Salary at time of offer is determined based on these and other factors as associated with the job and job level. The above statements describe the principal and essential functions, but not all functions that may be inherent in the job.  This job requires the ability to perform duties contained in the job description for this position, including, but not limited to, the above requirements.  Reasonable accommodations will be made for otherwise qualified applicants, as needed, to enable them to fulfill these requirements. The Auto Club Group, and all its affiliated companies, is an equal opportunity employer.  All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, disability or protected veteran status. Regular and reliable attendance is essential for the function of this job. AAA The Auto Club Group is committed to providing a safe workplace. Every applicant offered employment within The Auto Club Group will be required to consent to a background and drug screen based on the requirements of the position.