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BlueCross BlueShield of South Carolina · 1 day ago

FCMB Claims Customer Service Advocate II (Part-time)

Myrtle Beach, SC

Part-time

Onsite

Entry Level

2+ years exp

BlueCross BlueShield of South Carolina is seeking a Claims Customer Service Advocate II to handle routine correspondence and telephone inquiries related to claims or appeals. The role involves identifying incorrectly processed claims, completing adjustments, and ensuring compliance with department guidelines while providing excellent customer service.

Financial ServicesHealth CareHealth InsuranceInsuranceMedical

No H1B

Security Clearance Required

U.S. Citizen Only

Responsibilities

Research and respond to telephone inquiries according to desk procedures, ensuring that contract standards and objectives for timeliness, productivity, and quality are met

Research and respond to written inquiries and identify incorrectly processed claims and complete the adjustment and/or reprocessing action according to department guidelines. This may include initiating, documenting, and processing the request to completion. Initiate recoupments as necessary

Identify complaints and inquiries of a complexity level that cannot be resolved following desk procedures and guidelines and refer these to a lead or manager for resolution. Identifies and reports potential fraud and abuse situations

Complete projects and/or assignments related to claims processing and customer service functions in the department

Qualification

Claims processing experienceCustomer service experienceMicrosoft OfficeBusiness math proficiencyVerbal communication skillsWritten communication skillsDiscretion with confidential information

Required

High School Diploma or equivalent

2 years of customer service experience OR 1 year of claims or appeals processing experience and 1 year of customer service experience OR Bachelor's Degree in lieu of work experience

Good verbal and written communication skills

Strong customer service skills

Good spelling, punctuation and grammar skills

Basic business math proficiency

Ability to handle confidential or sensitive information with discretion

Microsoft Office

Benefits

Subsidized health plans, dental and vision coverage

401k retirement savings plan with company match

Life Insurance

Paid Time Off (PTO)

On-site cafeterias and fitness centers in major locations

Education Assistance

Service Recognition

National discounts to movies, theaters, zoos, theme parks and more

Company

BlueCross BlueShield of South Carolina

Glassdoor3.6

For more than six decades, BlueCross BlueShield of South Carolina has been part of the national landscape. Our roots are firmly embedded in the state.

Founded in 1946

Columbia, South Carolina, USA

10001+ employees