• Review claims in utilization review queues for medical necessity and authorization status; determine appropriate processing based on coding and plan language. • Support the daily operations of the Utilization Review department by assisting senior UR team members with case review activities. • Conduct outreach calls and collect data using established scripts, tools, and protocols, while maintaining productivity and service standards. • Process correspondence and faxes in accordance with timeliness standards; escalate to clinical team members when appropriate. • Perform clerical and administrative tasks, including scanning, document retrieval, and urgent claims processing support. • Communicate clearly, professionally, and courteously with internal and external stakeholders to resolve issues. • Provide written direction to other team members (nurses, claims auditors) to support accurate claims processing. • Maintain current knowledge of Standard Operating Procedures, member benefits, rights, and responsibilities. • Ensure compliance with BCBS Association standards and company policies. • Complete other related duties and projects as assigned.

• Join our team at Company and build a meaningful career in employee benefits solutions. • Review claims in utilization review queues for medical necessity and authorization status. • Support the daily operations of the Utilization Review department by assisting senior UR team members. • Conduct outreach calls and collect data using established scripts, tools, and protocols. • Process correspondence and faxes in accordance with timeliness standards. • Perform clerical and administrative tasks, including scanning, document retrieval, and urgent claims processing support. • Communicate clearly, professionally, and courteously with internal and external stakeholders. • Provide written direction to other team members to support accurate claims processing. • Maintain current knowledge of Standard Operating Procedures and member benefits. • Ensure compliance with BCBS Association standards and company policies. • Complete other related duties and projects as assigned.

• Complete field surveys in accordance with departmental standards • Prepare technical reports on the risks surveyed • Assist the risk in preventing and/or reducing the loss potential • Manage time and territory to complete all assignments within established time frames

• Develop and implement fundraising strategies, in coordination with program and development directors, to meet or exceed programmatic annual and long-term fundraising goals • Identify, cultivate, solicit, and steward high-net-worth individuals • Research and pursue grant opportunities from private foundations and corporate entities, and lead on submission of proposals and reports • Coordinate donor communications, including updates on conservation impact, thank-you letters, and other personalized outreach • Coordinate donor recognition efforts and stewardship/cultivation activities to build long-term engagement • Uphold the highest level of grant stewardship • Ensure compliance with gift acceptance, reporting standards, and donor intent • Track fundraising progress and maintain accurate donor and prospect records in ABC’s CRM (EveryAction), and other grant tracking systems • Help develop and maintain program budgets in coordination with program, finance, and other development team members • Stay informed about trends in philanthropy, conservation funding, and donor engagement best practices • Provide input into conservation planning and project implementation • Assist with projects as requested