Customer Service Advocate II

Pgba, Llc; Columbia (SC); Presencial; USD 32.000 - 42.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Subsidized health plans

Dental and vision coverage

401K retirement savings plan with 401k

Life Insurance

Paid Time Off (PTO)

On-site cafeterias and fitness centers

Wellness program

Tuition assistance

Service recognition

Employee Assistance

Discounts to movies, theaters, zoos, &

Theme parks and more

Descripción de la vacante

BlueCross BlueShield of South Carolina is seeking a Customer Service Advocate II for an on-site role in Columbia. You will handle customer inquiries, process claims and appeals, and ensure timely, accurate documentation within established procedures.

The position requires strong communication, confidentiality, and user proficiency with Microsoft Office; a high school diploma is required, with a bachelor’s degree acceptable as a substitute for work experience.

Formación

• High School Diploma or equivalent required.
• 1 year of experience including claims/appeals processing or related support.
• Bachelor’s degree may substitute for work experience.
• Proficient in Microsoft Office and document handling.

Responsabilidades

• Responds to written and/or telephone inquiries per desk procedures, ensuring contract standards and timeliness are met.
• Examines and processes claims and/or non-medical appeals according to guidelines and coding verification.
• Identifies and refers complex issues to a lead or manager for resolution; reports suspected fraud or system errors.

Conocimientos

Good Verbal and Written Communication

Strong Customer Service Skills

Spelling, Punctuation and Grammar

Basic Business Math Proficiency

Confidentiality & Discretion

Educación

High School Diploma or equivalent

Bachelor’s degree may substitute for work experience

Herramientas

Microsoft Office

Descripción del empleo

## Customer Service Advocate IIApply: On-site: Columbia, South Carolina: Full time: Posted Yesterday: End Date: November 7, 2026 (1 day left to apply): R1053072# **Summary**Provides prompt, accurate, thorough and courteous responses to all customer inquiries. Inquiries may be non-routine and require deviation from standard screens, scripts, and procedures. Performs research as needed to resolve inquiries.# **Description**Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but we've been part of the national landscape for more than seven decades, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina and much more. We are one of the nation's leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies, allowing us to build on various business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team! **Position Purpose**:Provides prompt, accurate, thorough and courteous responses to all customer inquiries. Inquiries may be non-routine and require deviation from standard screens, scripts, and procedures. Performs research as needed to resolve inquiries.**Location:**This position is full-time (40 hours/week) Monday through Friday in a typical office environment. You will work an 8-hour sift scheduled during our normal business hours of 8:00 AM - 5:00 PM. It may be necessary, given the business need to work occasional overtime. You may be required to travel between buildings. This role is located on-site at 4101 Percival Road; Columbia SC. Trainingwill be onsite Monday-Friday 8:00 AM -5 PM for approximately 8-10 weeks. **Sponsorship**: This position is not eligible for sponsorship now or in the future. **What You’ll Do:*** Responds to written and/or telephone inquiries according to desk procedures, ensuring that contract standards and objectives for timeliness, productivity, and quality are met. Accurately documents inquiries. Identifies incorrectly processed claims and processes adjustments and reprocessing actions according to department guidelines.* Examines and processes claims and/or non-medical appeals according to business/contract regulations, internal standards and examining guidelines. Enters claims into the claim system after verification of correct coding of procedures and diagnosis codes. Ensures claims are processing according to established quality and production standards.* Identifies complaints and inquiries of a complex level that cannot be resolved following desk procedures and guidelines and refers these to a lead or manager for resolution. Identifies and promptly reports and/or refers suspected fraudulent activities and system errors to the appropriate departments. **To Qualify for This Position, You’ll Need the Following:*** **Required Education:*** A High School Diploma or equivalent* **Required Work Experience:*** 1-year of experience including 1-year claims/appeals processing, customer service, or other related support area **OR** bachelor’s degree in lieu of work experience.* **Required Skills and Abilities:*** Good Verbal and Written Communication Skills* Strong Customer Service Skills* Good Spelling, Punctuation and Grammar Skills.* Basic Business Math Proficiency.* Ability to Manage Confidential or Sensitive Information with Discretion.* **Required Software and Tools:*** Microsoft Office. **What We Prefer that you Have the Following:*** Associate degree* (2) years-of claims processing or call center experience.* Knowledge of word processing, spreadsheet, and database software. **Our comprehensive benefits package includes the following:**We offer our employees great benefits and rewards. You will be eligible to participate in the benefits the first of the month following 28 days of employment. * Subsidized health plans, dental and vision coverage* 401K retirement savings plan with company match* Life Insurance* Paid Time Off (PTO)* On-site cafeterias and fitness centers in major locations* Wellness program and healthy lifestyle premium discount* Tuition assistance* Service recognition* Employee Assistance* Discounts to movies, theaters, zoos, theme parks and more **What We can Do for You:**We strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company. **What to Expect Next:**After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements.**Equal Employment Opportunity Statement** BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilities and protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations. We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company. If you need special assistance or an accommodation while seeking employment, please email [e-mail] or call 800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis. We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here's more information.Some states have required notifications. Here's more information.