Healthcare Claims Advocate II: Customer Service

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

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.