Claims Customer Service Advocate

Kelly; Myrtle Beach (SC); On-site; USD 36,000 - 42,000; Full time

Benefits offered by this job

Overtime opportunities

Healthcare benefits

Paid holidays

Job summary

Kelly is seeking a Claims Customer Service Advocate II in Myrtle Beach, SC. The role involves handling customer inquiries, reviewing and adjudicating claims, and ensuring timely resolutions with accuracy.

The position pays $17.75 per hour and follows a standard 8:00am–5:00pm shift, with potential overtime opportunities in a supportive healthcare setting. This role emphasizes customer service excellence, adherence to policies, and the ability to identify and escalate complex issues when needed.

Qualifications

• Experience in customer service, preferably in healthcare or insurance.
• Strong communication skills and ability to provide courteous, accurate responses.
• Attention to detail and ability to follow department guidelines.
• Ability to research and resolve inquiries and escalate when needed.
• Shift availability for 1st shift hours.

Responsibilities

• Respond to customer inquiries via phone, written correspondence, web, or in-person.
• Research and resolve customer inquiries to ensure timely resolutions.
• Review and adjudicate claims and non-medical appeals per policies.
• Process claim adjustments and reprocessing per guidelines.
• Enter claims into system and verify coding of procedures and diagnoses.
• Ensure claims are processed according to quality and production standards.
• Refer complex complaints and inquiries to a lead or manager when necessary.
• Identify and report potential fraud and abuse situations.

Skills

Customer service

Communication skills

Attention to detail

Issue escalation

Research skills

Job description

For those who want to keep growing, learning, and evolving. We at Kelly® hear you, and we’re here for you! We’re seeking a Claims Customer Service Advocate II to work at a leading healthcare organization in Myrtle Beach, SC. Sound good? Take a closer look below. You owe it to yourself to consider this great new opportunity.

Salary/Pay Rate/Compensation: $17.75 per hour

Shift: 8:00am to 5:00 PM

Credit Check REQUIRED

Why you should apply to be Claims Customer Service Advocate II:

• Competitive pay rate with opportunities for overtime.
• Work with a reputable organization in the healthcare industry.
• Gain experience in claims processing and customer advocacy.
• Positive, professional work environment focused on growth and development.
• Opportunity to expand your expertise in customer service and healthcare claims.

What’s a typical day as Claims Customer Service Advocate II?

• Responding to customer inquiries via phone, written correspondence, web, or in-person, including non-routine inquiries requiring deviation from standard procedures.
• Researching and resolving customer inquiries to ensure effective and timely resolutions.
• Reviewing and adjudicating claims and/or non-medical appeals, determining whether to return, deny, or pay claims in alignment with organizational policies.
• Processing claims adjustments and reprocessing actions following department guidelines.
• Entering claims into the system after verifying correct coding of procedures and diagnosis codes.
• Ensuring claims are processed according to quality and production standards.
• Referring complex complaints and inquiries to a lead or manager when necessary.
• Identifying and reporting potential fraud and abuse situations.

This Job Might Be An Outstanding Fit If You

• Have previous experience in customer service, preferably in a healthcare or insurance environment.
• Are comfortable handling complex inquiries and performing research to resolve issues.
• Possess strong communication skills and a commitment to providing courteous, accurate, and timely responses.
• Demonstrate attention to detail and the ability to follow department guidelines and procedures.
• Are able to identify and elevate issues appropriately.
• Are available to work 1st shift hours.

As part of our promise to talent, Kelly supports those who work with us through a variety of benefits, perks, and work-related resources. Please note: The following benefits reflect Kelly's general offerings. Eligibility may vary by assignment, location, and job type. Kelly offers eligible employees voluntary benefit plans including medical, dental, vision, telemedicine, term life, whole life, accident insurance, critical illness, a legal plan, and short-term disability. As a Kelly employee, you will have access to a retirement savings plan, service bonus and holiday pay plans (earn up to eight paid holidays per benefit year), and a transit spending account. In addition, employees are entitled to earn paid sick leave under the applicable state or local plan.

Get a complete career fit with Kelly®.

You’re looking to keep your career moving onward and upward, and we’re here to help you do just that. Our staffing experts connect you with top companies for opportunities where you can learn, grow, and thrive. Jobs that fit your skills and experience, and most importantly, fit right on your path of where you want to go in your career.

About Kelly

Work changes everything. And at Kelly, we’re obsessed with where it can take you. To us, it’s about more than simply accepting your next job opportunity. It’s the fuel that powers every next step of your life. It’s the ripple effect that changes and improves everything for your family, your community, and the world. Which is why, here at Kelly, we are dedicated to providing you with limitless opportunities to enrich your life-just ask the 300,000 people we employ each year.

Kelly is committed to providing equal employment opportunities to all qualified employees and applicants regardless of race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, age, marital status, pregnancy, genetic information, or any other legally protected status, and we take affirmative action to recruit, employ, and advance qualified individuals with disabilities and protected veterans in the workforce. Requests for accommodation related to our application process can be directed to the Kelly Human Resource Knowledge Center. Kelly complies with the requirements of California’s state and local Fair Chance laws. A conviction does not automatically bar individuals from employment. Kelly participates in E-Verify and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in the U.S.

Kelly may use AI-powered tools during the recruitment and hiring process. For full details, including how Kelly uses AI, your rights, and how to request a reasonable accommodation, visit the Recruitment Artificial Intelligence Notice.