Claims & Appeals Specialist II

Southcarolinablues; Columbia (SC); Hybride; USD 42 000 - 56 000; Plein temps

Avantages offerts par ce poste

On-site cafeterias

Fitness centers

401k with company match

PTO

Education Assistance

Résumé du poste

BlueCross BlueShield of South Carolina is seeking a Claims Customer Service Advocate II to respond to inquiries and adjudicate claims in Columbia, SC. The role requires accuracy, discretion, and strong communication to support members and providers.

The position is full-time, on-site at 4101 Percival Road with possible overtime and weekends. Training is 8:00am–4:30pm, 40 hours/week, and benefits are included from the first month after 28 days of employment.

Qualifications

• High School Diploma or equivalent required.
• 2 years of customer service experience including 1 year claims or appeals processing, or a Bachelor's degree in lieu of experience.
• Strong verbal and written communication; ability to handle confidential information.

Responsabilités

• Respond to customer inquiries via phone, email, web, or walk-ins with accuracy and courtesy.
• Identify and process adjusted or reprocessed claims according to guidelines.
• Examine claims/appeals per regulations and enter data into the system with correct coding.

Connaissances

Customer service

Communication

Research

MS Office

Formation

High School Diploma or equivalent

Bachelor's Degree (in lieu of work experience)

Outils

Microsoft Office

Description du poste

BlueCross BlueShield of South Carolina is seeking a Claims Customer Service Advocate II to respond to inquiries and adjudicate claims in Columbia, SC. The role requires accuracy, discretion, and strong communication to support members and providers.

The position is full-time, on-site at 4101 Percival Road with possible overtime and weekends. Training is 8:00am–4:30pm, 40 hours/week, and benefits are included from the first month after 28 days of employment.