Claims Customer Advocate II - On-Site Support Pro

Pgba, Llc; Myrtle Beach (SC); Hybrid; USD 42,000 - 54,000; Full time

Benefits offered by this job

Health insurance

401K retirement savings with company 1

Paid Time Off (PTO)

On-site cafeterias and fitness centers

Job summary

BlueCross BlueShield of South Carolina is seeking a Claims Customer Service Advocate II to support on-site in Myrtle Beach, SC. You will handle routine inquiries, document interactions, and process claim adjustments and reprocessing per guidelines.

The role is full-time (40 hours/week) with 9am–6pm shifts, and training 8am–5pm for 6–8 weeks. U.S. citizenship is required for security clearance; sponsorship is not offered. Benefits include health coverage and 401K, among others.

Qualifications

• High school diploma or equivalent required; bachelor's degree acceptable in lieu of work experience.
• 1 year of claims/appeals processing or related customer service experience, or a bachelor’s degree.
• Strong verbal and written communication and basic math skills.
• Ability to handle confidential information with discretion.

Responsibilities

• Respond to written and telephone inquiries about claims or appeals according to desk procedures.
• Identify incorrectly processed claims and perform adjustments and reprocessing actions.
• Enter claims into the system after verifying procedure and diagnosis codes.
• Refer complex issues to a lead or manager and report suspected fraud or system errors.

Skills

Verbal communication

Written communication

Customer service

Confidential information handling

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 Customer Service Advocate II to support on-site in Myrtle Beach, SC. You will handle routine inquiries, document interactions, and process claim adjustments and reprocessing per guidelines.

The role is full-time (40 hours/week) with 9am–6pm shifts, and training 8am–5pm for 6–8 weeks. U.S. citizenship is required for security clearance; sponsorship is not offered. Benefits include health coverage and 401K, among others.