Facebook · 2 months ago
Claims Customer Service Advocate II
BlueCross BlueShield of South Carolina is currently hiring for a Claims Customer Service Advocate II. This role is responsible for responding to customer inquiries and performing research to resolve non-routine inquiries, as well as reviewing and adjudicating claims and non-medical appeals.
Computer Software
Responsibilities
You'll ensure effective customer relations by responding accurately, timely and courteously to our customers. These responses may be by telephone, written, web or walk-in inquiries. You will handle situations which may require a different set of responses or extensive research. Adhering to department guidelines, you will also identify claims that have been incorrectly processed and will enact process adjustments and reprocessing actions
You will examine and process claims and/or non-medical appeals while ensuring business/contract regulations, internal standards and examining guidelines. Another responsibility is to enter claims into the claim system after verifying correct coding of procedures and diagnosis codes. Claims must be processed according to established quality and production standards
You'll identify complaints and inquiries that may be complex and that cannot be resolved following usual procedures and guidelines and refer to a team lead or manager for resolution. You will also identify and report fraud and abuse situations
Qualification
Required
High School Diploma or equivalent
2 years of customer service experience including 1 year claims or appeals processing 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
Preferred
Provider Customer Service Experience
Benefits
401(k) retirement savings plan with company match.
Subsidized health plans and free vision coverage.
Life insurance.
Paid annual leave - the longer you work here, the more you earn.
Nine paid holidays.
On-site cafeterias and fitness centers in major locations.
Wellness programs and a healthy lifestyle premium discount.
Tuition assistance.
Service recognition.
Company
The Facebook company is now Meta. Meta builds technologies that help people connect, find communities, and grow businesses.
H1B Sponsorship
Facebook has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2022 (942)
2021 (5811)
2020 (4476)
Funding
Current Stage
Late StageLeadership Team
Recent News
Business Live
2025-11-03
2025-11-01
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