BlueCross BlueShield of South Carolina · 21 hours ago
Claims Customer Service Advocate I
Columbia, SC
Full-time
Onsite
Entry Level
1+ years expBlueCross BlueShield of South Carolina is responsible for managing health insurance claims and customer service. The Claims Customer Service Advocate I role involves responding to inquiries, processing claims, and ensuring compliance with organizational policies and procedures.
Financial ServicesHealth CareHealth InsuranceInsuranceMedical
Responsibilities
Responds to written and/or telephone inquiries according to desk procedures, ensuring that contract standards and objectives for timeliness, productivity, and quality are met
Accurately documents inquiries
Identifies incorrectly processed claims and processes adjustments and reprocessing actions according to department guidelines
Examines and processes claims and/or non-medical appeals according to business/contract regulations, internal standards and examining guidelines
Enters claims into the claim system after verification of correct coding of procedures and diagnosis codes
Ensures claims are processing according to established quality and production standards
Identifies complaints and inquiries of a complex level that cannot be resolved following desk procedures and guidelines and refers these to a lead or manager for resolution
Identifies and promptly reports and/or refers suspected fraudulent activities and system errors to the appropriate departments
Qualification
Required
High School Diploma or equivalent
1 year of experience in a claims/appeals processing, customer service, or other related support area 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
Company
BlueCross BlueShield of South Carolina
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.
10001+ employees
Funding
Current Stage
Late StageLeadership Team
April Richardson
Vice President and Chief Operating Officer of Companion Benefit Alternative
Alli McGary
Talent Acquisition Partner
Recent News
2025-09-13
UPSTATE BUSINESS JOURNAL
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