Claims & Appeals Advocate II

ourhrconnect; Myrtle Beach (SC); On-site; USD 36,000 - 48,000; Full time

Benefits offered by this job

Health insurance

Dental and vision coverage

401K with company match

Life Insurance

Paid Time Off

Job summary

BlueCross BlueShield of South Carolina is seeking a claims processor to respond to routine correspondence and phone inquiries related to claims or appeals. The role identifies incorrectly processed claims and completes adjustments and reprocessing actions, working on-site in Myrtle Beach, SC.

The position requires a high school diploma (or equivalent) with 1 year of claims/appeals processing experience or a bachelor’s degree in lieu of experience.

Qualifications

• High School Diploma or equivalent.
• 1 year of claims/appeals processing, customer service, or 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 Manage Confidential or Sensitive Information with Discretion.
• Microsoft Office proficiency.

Responsibilities

• Responds to written and/or telephone inquiries per desk procedures, ensuring timeliness, productivity, and quality.
• Examines and processes claims and/or non-medical appeals according to regulations and standards; enters claims into the system after verification of coding.
• Identifies and reports complex issues to a lead or manager; flags potential fraud and system errors.

Skills

Communication skills

Customer service

Discretion

Microsoft Office

Basic math

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 claims processor to respond to routine correspondence and phone inquiries related to claims or appeals. The role identifies incorrectly processed claims and completes adjustments and reprocessing actions, working on-site in Myrtle Beach, SC.

The position requires a high school diploma (or equivalent) with 1 year of claims/appeals processing experience or a bachelor’s degree in lieu of experience.