Claims Customer Service Advocate II (11:30 am to 8:00 pm) - Remote after onsite training in Col[...]

BlueCross BlueShield of South Carolina; Columbia (SC); Hybrid; USD 35,000 - 55,000; Full time

Job summary

An established industry player is seeking a Claims Customer Service Advocate II to join their dedicated team. This role involves providing exceptional customer service by accurately responding to inquiries and processing claims. You will play a crucial part in ensuring compliance with business regulations and identifying complex issues for resolution. With a strong focus on customer satisfaction, you will thrive in a supportive environment that values your contributions. Enjoy a competitive pay structure and a comprehensive benefits package, including health plans and retirement savings. If you are passionate about helping others and have a keen eye for detail, this opportunity is perfect for you.

Benefits

401(k) retirement savings plan

Health plans

Free vision coverage

Life insurance

Paid annual leave

Nine paid holidays

On-site cafeterias

Fitness centers

Tuition assistance

Wellness programs

Qualifications

• Two years of customer service experience including claims processing.
• Proficiency in Microsoft Office is required.

Responsibilities

• Respond to inquiries accurately and courteously.
• Process claims according to business regulations.
• Identify and report potential fraud situations.

Skills

Customer Service

Claims Processing

Microsoft Office

Education

High School Diploma

Bachelor's Degree

Job description

Claims Customer Service Advocate II (11:30 am to 8:00 pm) - Remote after onsite training in Columbia, SC

Pay: Competitive

Location: Columbia, South Carolina

Employment type: Full-Time

Job Description

• Provide effective customer relations by responding accurately, timely, and courteously to inquiries.
• Handle situations which may require adaptation of response or extensive research.
• Examine and process claims and/or non-medical appeals according to business/contract regulations, internal standards, and examining guidelines.
• Identify complaints and inquiries of a complex level that cannot be resolved following desk procedures and guidelines and refer these to a lead or manager for resolution.
• Identify and report potential fraud and abuse situations.

Qualifications

• High School Diploma or equivalent required.
• Two years of customer service experience including one year claims or appeals processing, or a Bachelor's Degree in lieu of work experience.
• Proficiency in Microsoft Office.

Preferences

• Customer Service experience in a call center or medical office.
• Experience with FSA accounts and/or banking industry.

Benefits

• 401(k) retirement savings plan with company match.
• Health plans and free vision coverage.
• Life insurance.
• Paid annual leave.
• Nine paid holidays.
• On-site cafeterias and fitness centers in major locations.
• Wellness programs and a healthy lifestyle premium discount.
• Tuition assistance.
• Service recognition.

Additional Information

• Participation in E-Verify and compliance with the Pay Transparency Nondiscrimination Provision.
• Equal Opportunity Employer.
• BlueCross BlueShield of South Carolina and subsidiaries maintain a policy of nondiscrimination in employment.
• Committed to providing reasonable accommodations to individuals with disabilities.

About the company

BlueCross BlueShield of South Carolina is a recognized name in health insurance, serving Palmetto State citizens for over 70 years. As the only South Carolina-owned and operated health insurance carrier, we are one of the state's largest employers.