Customer Service Advocate II Part Time 11AM-3PM

001 BlueCross and BlueShield of South Carolina; Florence (SC); On-site; USD 21,000 - 30,000; Part time

Job summary

BlueCross BlueShield of South Carolina is hiring a part‑time Customer Service Advocate II in Florence, SC. The role involves responding to routine inquiries about claims/appeals, identifying incorrectly processed claims, and performing adjustments and reprocessing actions. The position is on-site with a 20-hour work week and structured training.

Work hours are Monday–Friday, 11:00am–3:00pm, with training 8:00am–4:30pm for five weeks. Sponsorship is not available now or in the future.

Qualifications

• High School Diploma or equivalent is required.
• 2 years of customer service experience OR 1 year of claims/appeals processing plus 1 year of customer service, OR a Bachelor's degree in lieu of work experience.
• Strong verbal and written communication, with good spelling, punctuation, and grammar.
• Proficiency in basic business math and handling confidential information.
• Microsoft Office is required.

Responsibilities

• Respond to telephone inquiries according to desk procedures.
• Respond to written inquiries and adjust claims per guidelines.
• Initiate, document, and process requests to completion.
• Initiate recoupments as necessary.
• Escalate complex inquiries to a lead or manager for resolution.
• Identify potential fraud and abuse situations.
• Complete projects related to claims processing and customer service.

Skills

Verbal communication

Written communication

Customer service

Attention to detail

Discretion

Education

High School Diploma or equivalent

Bachelor's degree in lieu of experience

Tools

Microsoft Office

Job description

Summary

We are currently hiring for a part-time Customer Service Advocate II to join BlueCross BlueShield of South Carolina. You will be responsible for responding to routine correspondence and telephone inquiries pertaining to claims or appeals. Identifies incorrectly processed claims and completes adjustments and related reprocessing actions. Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades we’ve been part of the national landscape, 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 that allows us to build on a variety of business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team! Here is your opportunity to join a dynamic team at a diverse company with secure, community roots and an innovative future.

Description Logistics

PGBA– one of BlueCross BlueShield's South Carolina subsidiary companies.

Location: This position is part-time (20-hours/week) Monday-Friday from 11:00am to 3:00pm and training will be Monday-Friday from 8am-4:30pm for five weeks in a typical office environment.

This role is located on-site at 200 North Dozier Boulevard, Florence, SC 29501.

Sponsorship: This position is not eligible for sponsorship now or in the future.

What You’ll Do

• Researches and responds to telephone inquiries according to desk procedures, ensuring that contract standards and objectives for timeliness, productivity, and quality are met.
• Research and respond to written inquiries and identify incorrectly processed claims and completes the adjustment and/or reprocessing action according to department guidelines.
• This may include initiating, documenting, and processing the request to completion.
• Initiate recoupments as necessary.
• Identifies complaints and inquiries of a complexity level that cannot be resolved following desk procedures and guidelines and refers these to a lead or manager for resolution.
• Identifies and reports potential fraud and abuse situations.
• Completes projects and/or assignments related to claims processing and customer service functions in the department.

To Qualify for This Position, You’ll Need the Following:

• Required Education: High School Diploma or equivalent
• Required Work Experience: 2 years of customer service experience OR 1 year of claims or appeals processing experience and 1 year of customer service experience 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 handle confidential or sensitive information with discretion.
• Required Software and Other Tools: Microsoft Office.
• Work Environment: Typical office environment.
• What We Can Do for You: We understand the value of a diverse and inclusive workplace and 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.

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.

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Company Overview

PGBA, LLC is a leading provider of administrative services for the TRICARE health benefit program and health benefit programs of Veteran’s Health Administration for both state and federal governments. The company has offices in Florence, Surfside Beach, and Columbia, South Carolina. PGBA employees work in an atmosphere that is conducive to growth and on that fosters a focus on personal and professional development with an environment made up of people from different parts of the world with diverse cultural Excellent benefits, as well as a competitive compensation program, make us one of the leading employers in today’s corporate market.

Veterans Welcome

PGBA is a strong supporter of our veterans, and many service men and women have joined our ranks. We’ve found the dedication, work ethic and job skills that serve well in the military excel in many of our lines of business, and we proudly have veterans filling positions in Human Resources, Information Technology, Customer Service, Operations, General Services and more. If you are a full‑time employee in the National Guard or Reserves, we will even cover the difference in your pay if you are called to active duty.