Claims Support & Adjudication Associate I

Pgba, Llc; Columbia, Northern (SC, KY); Hybrid; USD 40,000 - 60,000; Full time

Benefits offered by this job

Health insurance

Dental and vision coverage

401K with company match

Paid Time Off

On-site cafeteria

Wellness program

Tuition assistance

Employee recognition

Job summary

PGBA, located in Columbia, SC, seeks a Claims Customer Service Advocate I to handle routine inquiries and adjudicate claims. This on-site role is full-time, with a standard 8-hour schedule and initial training weeks.

You will process claims, make adjustments, and handle customer interactions with discretion. Requirements include a High School Diploma (Bachelor's preferred) and 1 year in claims or related support.

Qualifications

• High school diploma or equivalent required; bachelor's degree preferred or in lieu of experience.
• 1 year of claims/appeals processing, customer service, or related support experience.
• Strong written and verbal communication, ability to handle confidential information.

Responsibilities

• Responds to inquiries via written or telephone channels per desk procedures.
• Identifies incorrectly processed claims and processes adjustments and reprocessing actions.
• Examines and processes claims and non-medical appeals per regulations and guidelines.
• Enters claims into the system with verified coding and ensures quality and timeliness.

Skills

Claims processing

Customer service

Communication skills

Confidential data handling

Education

High School Diploma

Bachelor's degree in a related field

Tools

Microsoft Office

Job description

PGBA, located in Columbia, SC, seeks a Claims Customer Service Advocate I to handle routine inquiries and adjudicate claims. This on-site role is full-time, with a standard 8-hour schedule and initial training weeks.

You will process claims, make adjustments, and handle customer interactions with discretion. Requirements include a High School Diploma (Bachelor's preferred) and 1 year in claims or related support.