Claims Advocate II – On-Site Customer Support

Southcarolinablues; Columbia (SC); Hybrid; USD 42,000 - 54,000; Full time

Benefits offered by this job

Subsidized health plans

401K with company match

Life Insurance

PTO

Job summary

BlueCross BlueShield of South Carolina is seeking a FCMB Claims Customer Service Advocate II for an on-site role in Columbia, SC. The position requires handling routine inquiries and processing claims or appeals, with training and a 40-hour work week within 9 AM–6 PM and an initial 6–8 week training period from 8:00 AM to 5:00 PM.

The role requires a high school diploma or equivalent and 1 year in claims/appeals processing or related customer service, or a bachelor’s degree in lieu of

Qualifications

• High School Diploma or equivalent required.
• 1 year of claims/appeals processing or related customer service experience, or a bachelor’s degree in lieu of experience.
• Strong verbal and written communication skills; accuracy in documentation and data entry.

Responsibilities

• Responds to written and/or telephone inquiries according to desk procedures, ensuring timeliness, productivity and quality.
• Accurately documents inquiries and processes adjustments/reprocessing of claims per guidelines.
• Examines and processes claims/appeals according to regulations and internal standards.
• Enters claims into the system after verifying coding of procedures and diagnoses.
• Identifies complex issues for escalation to a lead or manager.
• Reports suspected fraudulent activity or system errors to appropriate departments.

Skills

Verbal comms

Written comms

Customer service

Spelling/Grammar

Business math

Discretion

Education

High School Diploma or equivalent

Bachelor’s degree (in lieu of experience)

Tools

Microsoft Office

Job description

BlueCross BlueShield of South Carolina is seeking a FCMB Claims Customer Service Advocate II for an on-site role in Columbia, SC. The position requires handling routine inquiries and processing claims or appeals, with training and a 40-hour work week within 9 AM–6 PM and an initial 6–8 week training period from 8:00 AM to 5:00 PM.

The role requires a high school diploma or equivalent and 1 year in claims/appeals processing or related customer service, or a bachelor’s degree in lieu of